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Concomitant off-pump modified maze and coronary surgery.

Massimo A Mariani¹, Thijs Stoker, Marcoen F Scholten

¹Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. m.mariani@thorax.umcg.nl

The Annals of Thoracic Surgery

|May 31, 2011

Summary

This study combined a modified Maze procedure with off-pump coronary artery surgery for patients with atrial fibrillation. The approach proved safe and effective, with 75% of patients achieving sinus rhythm at midterm follow-up.

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Area of Science:

Cardiac Surgery
Electrophysiology
Atrial Fibrillation Treatment

Background:

Coronary artery disease (CAD) and atrial fibrillation (AF) frequently coexist.
Long-standing permanent atrial fibrillation poses challenges in patients undergoing cardiac surgery.
Current treatment options for concomitant AF during coronary artery bypass grafting (CABG) require evaluation.

Purpose of the Study:

To evaluate the midterm outcomes of a modified Cox-Maze III procedure using bipolar radiofrequency.
To assess the safety and efficacy of combining this modified Maze with off-pump coronary artery surgery.
To determine the feasibility of treating patients with both CAD and long-standing permanent AF simultaneously.

Main Methods:

A modified Cox-Maze III procedure utilizing bipolar radiofrequency ablation was performed.
The modified Maze procedure was concomitantly applied during off-pump coronary artery surgery.
The study included 12 patients with coronary artery disease and long-standing permanent atrial fibrillation.

Main Results:

All 12 patients were alive at a mean follow-up of 23 months.
75% (9 out of 12) of the patients achieved and maintained sinus rhythm.
The combined procedure demonstrated a favorable midterm outcome.

Conclusions:

The modified Maze procedure using bipolar radiofrequency is a safe and effective addition to off-pump coronary artery surgery.
This combined approach offers a viable treatment strategy for patients with concurrent coronary artery disease and long-standing permanent atrial fibrillation.
Further research can explore long-term outcomes and broader application of this technique.