Korean J Thorac Cardiovasc Surg.  2017 Jun;50(3):171-176. 10.5090/kjtcs.2017.50.3.171.

Treatment of Atrial Fibrillation in Elderly Patients with the Cox Maze Procedure Concurrently with Other Cardiac Operations

• Kuh JH
• Song JY
• Kim TY
• Kim JH
• Choi JB

• KMID: 2381899
• DOI: http://doi.org/10.5090/kjtcs.2017.50.3.171

Abstract

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.

Keyword

Arrhythmia; Surgery; Geriatrics; Heart atria; Heart valve disease

MeSH Terms

Aged*
Arrhythmias, Cardiac
Atrial Fibrillation*
Follow-Up Studies
Geriatrics
Heart Atria
Heart Valve Diseases
Humans
Methods
Survival Rate
Thoracic Surgery