An Experience of Cox-maze III Procedure for Chronic Atrial Fibrillation

Kim, Sam Hyun; Park, Yee Tae; Seo, Pil Won; Park, Sung Sik; Ryu, Jae Wook; Choi, Chang Hyu; Kim, Myung Ae; Lee, Myung Yong; Kim, Young Kwon

Abstract

During the past several years, the maze operation has become the most effective method of treatment for chronic atrial fibrillation. When the maze procedure is done concomittantly with other cardiac operations, surgeons, in their initial experiences, may be concerned about the additional operative risks and uncertainty of the results. We performed the Cox-maze III procedure in six cases of chronic atrial fibrillation associated with mitral, mitral & aortic, or coronary arterial disease. Maze III procedure was done with open mitral commissurotomy (3 cases), mitral valve replacement (1 case), aortic and mitral valve replacement (1 case), and two-vessel coronary bypass graft (1 case). In spite of rather prolonged aortic cross clamp time, cardiac recovery was uneventful in all cases. No cases required reexploration for postoperative bleeding. All patients showed regular sinus rhythms immediate or between 2 and 20 days postoperateratively. Transient postoperative supraventricular arrhythmarias were easily controlled by various antiarrhythmic agents. In follow up evaluations, all cases showed regular sinus rhythm on ECG and the right and left atrial transport function was confirmed by Doppler echocardiography in all except one. Though our experience was limited in case number, the Cox-maze III procedure was effective in controlling the chronic atrial fibrillation without serious additional operative risks.