Is there still a role for the classical Cox-Maze III?

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• The incidence of atrial fibrillation (AF) surgery is increasing, with diverse lesion sets and energy sources.
• Alternative energy sources simplify procedures but increase consumable costs.
• The classical Cox-Maze III procedure is the established gold standard for AF treatment due to its proven efficacy.

Purpose of the Study:

• To present the complete experience with the classical Cox-Maze III procedure.
• To evaluate the safety and efficacy of the Cox-Maze III in a cohort of patients.

Main Methods:

• A prospective study of 28 patients undergoing the classical Cox-Maze III procedure.
• Preoperative assessment and prospective follow-up were conducted for all participants.

Main Results:

• The study included 28 patients (mean age 65 years) undergoing the Cox-Maze III procedure between 2001 and 2003.
• 93% freedom from AF at follow-up (mean 15 months), with significant improvement in New York Heart Association class.
• No perioperative or late deaths, or thromboembolic events were observed; anti-arrhythmic medication use decreased.

Conclusions:

• The classical Cox-Maze III procedure demonstrates safety and efficacy in treating atrial fibrillation.
• Its proven long-term efficacy, safety, and cost-effectiveness make it a valuable treatment option.
• The procedure's perceived complexity should not preclude its consideration for AF patients.