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- Title
The Maze Procedure for the Treatment of Atrial Fibrillation: A minimally invasive approach.
- Authors
Niv Ad; Cox, James L.
- Abstract
Objectives: The standard Maze procedure has proven to be extremely effective in curing atrial fibrillation in thousands of patients worldwide. Until now it has required a median sternotomy and cardiopulmonary bypass. In order to simplify the standard approach, a minimally invasive technique was developed. We have recently applied this minimally invasive Maze procedure in 72 patients. Methods: The technique is dependent on the use of cryosurgery and the total number of atriotomies has been decreased from twelve to four. In addition to performing the Maze procedure, 32% of patients have had concomitant surgery via the minimally invasive approach including mitral valve repair/replacement and tricuspid valve repair. Results: Perioperative morbidity is improved following the minimally invasive approach in comparison to the standard approach with the incidence of temporary perioperative arrhythmias being decreased by 50%. The long-term recurrence of atrial fibrillation is 2.4% following the minimally invasive Maze procedure and 2.2% following the standard Maze procedure. The incidence of pacemaker requirements following the standard Maze procedure is 20% but only 6% following the minimally invasive Maze procedure. Both right atrial and left atrial transport function have been documented in 100% of patients following the minimally invasive Maze procedure. Conclusions: We believe that the minimally invasive Maze procedure is a substantial improvement over the standard approach in terms of patient morbidity while preserving the effectiveness of the Maze procedure in curing atrial fibrillation.
- Subjects
CATHETER ablation; ATRIAL fibrillation; ATRIAL arrhythmias; CARDIAC catheterization; MITRAL valve surgery; CARDIAC surgery
- Publication
Journal of Cardiac Surgery, 2004, Vol 19, Issue 3, p196
- ISSN
0886-0440
- Publication type
Article
- DOI
10.1111/j.0886-0440.2004.4036_1.x