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

Ja Hong Kuh1,2, Joon Young Song1, Tae Youn Kim1

  • 1Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School.

The Korean Journal of Thoracic and Cardiovascular Surgery
|June 9, 2017
PubMed

Insights

Concurrent Cox maze procedure (CMP) in elderly patients with atrial fibrillation (AF) shows high sinus rhythm conversion rates. This cardiac surgery approach appears safe, even with complex procedures, for older adults.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) management in elderly patients undergoing cardiac surgery presents challenges.
  • The Cox maze procedure (CMP) is effective for AF ablation but may increase surgical complexity.
  • Evaluating concurrent CMP in elderly patients is crucial for assessing its safety and efficacy.

Purpose of the Study:

  • To assess the outcomes of concurrent Cox maze procedure (CMP) in patients over 70 years old with atrial fibrillation (AF).
  • To determine the safety and efficacy of adding CMP to other cardiac operations in elderly patients.

Main Methods:

  • A prospective study enrolled 27 patients aged >70 years with AF undergoing concurrent CMP and other cardiac operations.
  • Patients had a high mean preoperative European System for Cardiac Operative Risk Evaluation score (8±11).
  • Follow-up included survival rates, rhythm conversion, and left atrial dimensions.

Main Results:

  • A low hospital mortality rate of 4% (1 death) was observed.
  • The 5-year cumulative survival rate was high at 92%.
  • At a mean follow-up of 51 months, 89% of patients achieved sinus rhythm conversion, with no significant difference in left atrial dimensions based on reduction plasty.

Conclusions:

  • Concurrent CMP in elderly patients (>70 years) with AF is associated with a high rate of sinus rhythm conversion.
  • This approach does not appear to significantly increase surgical risk despite the added complexity.
  • Adding CMP to other cardiac procedures in this demographic is a viable option for AF management.
Abstract

Keywords:
ArrhythmiaGeriatricsHeart atriaHeart valve diseaseSurgery

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