Key result
Concurrent Cox maze procedure achieves 89% sinus rhythm conversion in patients over 70.
Why the study?
Does the Cox maze procedure concurrently with other cardiac operations improve sinus rhythm conversion and survival in patients aged >70 years with atrial fibrillation?
Observational (n=27)
No
Does the Cox maze procedure concurrently with other cardiac operations improve sinus rhythm conversion and survival in patients aged >70 years with atrial fibrillation?
Concurrent Cox maze procedure during cardiac surgery in patients >70 years old is associated with high rates of sinus rhythm conversion and survival without prohibitive surgical risk.
May support concurrent maze in selected elderly AF patients; leaves open randomized confirmation of benefit.
BACKGROUND: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. METHODS: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was 8±11 (high risk). RESULTS: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow-up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium (53.4±7.5 cm) and the 19 patients who did not have reduction plasty (48.7±5.7 cm). CONCLUSION: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.
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Kuh et al. (2017) conducted an observational in Atrial fibrillation (n=27). Cox maze procedure concurrent with other cardiac operations was evaluated on Sinus rhythm conversion at final follow-up. In patients aged >70 years, the Cox maze procedure performed concurrently with other cardiac operations achieved an 89% rate of sinus rhythm conversion at a mean follow-up of 51 months.
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