Early and mid-term outcomes of concomitant cryosurgical Cox-Maze <b>Ⅳ</b> procedure in minimally invasive mitral valve surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Long ,  LIU Liming , ZHANG Hao , HU Jianguo , LUO Cheng , YANG Benli

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, P.R.China;

Corresponding author：

LIU Liming, Email: liulimingjia@csu.edu.cn

Keywords：

Minimally invasive mitral valve surgery; atrial fibrillation; cryoablation; Cox-Maze Ⅳ procedure

DOI：

10.7507/1007-4848.202011044

Video：

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Objective To analyze the early and mid-term safety and effectiveness of concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery.Methods We retrospectively reviewed the clinical data of 68 patients (28 males and 40 females with a mean age of 38.7±9.3 years) who underwent concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve and tricuspid surgery in the Department of Cardiovascular Surgery of the Second Xiangya Hospital from August 2013 to October 2017. The heart rhythm of the patients after surgery was supervised by 24 hour holter monitoring eletrocardiogram.Results No death occurred during operation and follow-up. One patient underwent reexploration for bleeding. The rate of sinus rhythm restored at the time of discharge was 95.8%. The rate of sinus rhythm restored at 6 months, 12 months, 24 months, 36 months after surgery was 93.5%, 91.6%, 90.3% and 89.5% respectively.Conclusion Concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery is quite safe and effective in treatment of rheumatic mitral valve disease and atrial fibrillation in the early and mid-term follow-up.

Citation： SONG Long, LIU Liming, ZHANG Hao, HU Jianguo, LUO Cheng, YANG Benli. Early and mid-term outcomes of concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 154-157. doi: 10.7507/1007-4848.202011044 Copy

1.	Cox JL, Churyla A, Malaisrie SC, et al. When is a Maze procedure a Maze procedure? Can J Cardiol, 2018, 34(11): 1482-1491.
2.	Cox JL, Schuessler RB, D'Agostino HJ, et al. The surgical treatment of atrial fibrillation Ⅲ. Development of a definitive surgical procedure. J Thorac Cardiovasc Surg, 1991, 101(4): 569-583.
3.	Badhwar V, Rankin JS, Damiano RJ, et al. The Society of Thoracic Surgeons 2017 clinical practice guidelines for the surgical treatment of atrial fibrillation. Ann Thorac Surg, 2017, 103(1): 329-341.
4.	陈和明, 刘立明, 胡建国. 右胸前外侧小切口微创二尖瓣置换术. 中南大学学报(医学版), 2010, 35(9): 1005-1008.
5.	李小冰, 刘立明, 宋珑, 等. 心房颤动冷冻消融在微创二尖瓣手术中的应用. 中南大学学报(医学版), 2016, 41(3): 295-299.
6.	宋珑, 刘立明, 李小冰, 等. 心脏瓣膜手术同期冷冻消融治疗心房颤动的临床研究. 中国胸心血管外科临床杂志, 2017, 24(5): 369-373.
7.	Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2020. [Epub ahead of print].
8.	McCarthy PM, Davidson CJ, Kruse J, et al. Prevalence of atrial fibrillation before cardiac surgery and factors associated with concomitant ablation. J Thorac Cardiovasc Surg, 2020, 159(6): 2245-2253.
9.	Ad N, Holmes SD, Friehling T. Minimally invasive stand-alone Cox Maze procedure for persistent and long-standing persistent atrial fibrillation: Perioperative safety and 5-year outcomes. Circ Arrhythm Electrophysiol, 2017, 10(11): e005352.
10.	Ad N, Holmes SD, Massimiano PS, et al. Long-term outcome following concomitant mitral valve surgery and Cox maze procedure for atrial fibrillation. J Thorac Cardiovasc Surg, 2018, 155(3): 983-994.
11.	Damiano RJ, J r, Bailey M. The Cox maze Ⅳ procedure for lone atrial fibrillation. Multimed Man Cardiothorac Surg, 2007, 2007(723): mmcts.2007.002758.
12.	Marchetto G, Anselmino M, Rovera C, et al. Results of cryoablation for atrial fibrillation concomitant with video-assisted minimally invasive mitral valve surgery. Semin Thorac Cardiovasc Surg, 2016, 28(2): 271-280.
13.	Ad N, Holmes SD. Early stable sinus rhythm associated with greater success 5 years after surgical ablation. Ann Thorac Surg, 2018, 105(5): 1370-1376.
14.	Gammie JS, Didolkar P, Krowsoski LS, et al. Intermediate-term outcomes of surgical atrial fibrillation correction with the CryoMaze procedure. Ann Thorac Surg, 2009, 87(5): 1452-1458.
15.	Avitall B, Kalinski A. Cryotherapy of cardiac arrhythmia: From basic science to the bedside. Heart Rhythm, 2015, 12(10): 2195-2203.
16.	Baust JG, Gage AA. Progress toward optimization of cryosurgery. Technol Cancer Res Treat, 2004, 3(2): 95-101.
17.	Ad N, Holmes SD, Rongione AJ, et al. Does surgical ablation energy source affect long-term success of the concomitant Cox Maze procedure? Ann Thorac Surg, 2017, 104(1): 29-35.
18.	Ad N. Decision-making in surgical treatment for stand-alone atrial fibrillation: minimally invasive Cox Maze procedure. Innovations (Phila), 2019, 14(6): 487-492.
19.	Golovchiner G, Mazur A, Kogan A, et al. Atrial flutter after surgical radiofrequency ablation of the left atrium for atrial fibrillation. Ann Thorac Surg, 2005, 79(1): 108-112.

1. Cox JL, Churyla A, Malaisrie SC, et al. When is a Maze procedure a Maze procedure? Can J Cardiol, 2018, 34(11): 1482-1491.
2. Cox JL, Schuessler RB, D'Agostino HJ, et al. The surgical treatment of atrial fibrillation Ⅲ. Development of a definitive surgical procedure. J Thorac Cardiovasc Surg, 1991, 101(4): 569-583.
3. Badhwar V, Rankin JS, Damiano RJ, et al. The Society of Thoracic Surgeons 2017 clinical practice guidelines for the surgical treatment of atrial fibrillation. Ann Thorac Surg, 2017, 103(1): 329-341.
4. 陈和明, 刘立明, 胡建国. 右胸前外侧小切口微创二尖瓣置换术. 中南大学学报(医学版), 2010, 35(9): 1005-1008.
5. 李小冰, 刘立明, 宋珑, 等. 心房颤动冷冻消融在微创二尖瓣手术中的应用. 中南大学学报(医学版), 2016, 41(3): 295-299.
6. 宋珑, 刘立明, 李小冰, 等. 心脏瓣膜手术同期冷冻消融治疗心房颤动的临床研究. 中国胸心血管外科临床杂志, 2017, 24(5): 369-373.
7. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2020. [Epub ahead of print].
8. McCarthy PM, Davidson CJ, Kruse J, et al. Prevalence of atrial fibrillation before cardiac surgery and factors associated with concomitant ablation. J Thorac Cardiovasc Surg, 2020, 159(6): 2245-2253.
9. Ad N, Holmes SD, Friehling T. Minimally invasive stand-alone Cox Maze procedure for persistent and long-standing persistent atrial fibrillation: Perioperative safety and 5-year outcomes. Circ Arrhythm Electrophysiol, 2017, 10(11): e005352.
10. Ad N, Holmes SD, Massimiano PS, et al. Long-term outcome following concomitant mitral valve surgery and Cox maze procedure for atrial fibrillation. J Thorac Cardiovasc Surg, 2018, 155(3): 983-994.
11. Damiano RJ, J r, Bailey M. The Cox maze Ⅳ procedure for lone atrial fibrillation. Multimed Man Cardiothorac Surg, 2007, 2007(723): mmcts.2007.002758.
12. Marchetto G, Anselmino M, Rovera C, et al. Results of cryoablation for atrial fibrillation concomitant with video-assisted minimally invasive mitral valve surgery. Semin Thorac Cardiovasc Surg, 2016, 28(2): 271-280.
13. Ad N, Holmes SD. Early stable sinus rhythm associated with greater success 5 years after surgical ablation. Ann Thorac Surg, 2018, 105(5): 1370-1376.
14. Gammie JS, Didolkar P, Krowsoski LS, et al. Intermediate-term outcomes of surgical atrial fibrillation correction with the CryoMaze procedure. Ann Thorac Surg, 2009, 87(5): 1452-1458.
15. Avitall B, Kalinski A. Cryotherapy of cardiac arrhythmia: From basic science to the bedside. Heart Rhythm, 2015, 12(10): 2195-2203.
16. Baust JG, Gage AA. Progress toward optimization of cryosurgery. Technol Cancer Res Treat, 2004, 3(2): 95-101.
17. Ad N, Holmes SD, Rongione AJ, et al. Does surgical ablation energy source affect long-term success of the concomitant Cox Maze procedure? Ann Thorac Surg, 2017, 104(1): 29-35.
18. Ad N. Decision-making in surgical treatment for stand-alone atrial fibrillation: minimally invasive Cox Maze procedure. Innovations (Phila), 2019, 14(6): 487-492.
19. Golovchiner G, Mazur A, Kogan A, et al. Atrial flutter after surgical radiofrequency ablation of the left atrium for atrial fibrillation. Ann Thorac Surg, 2005, 79(1): 108-112.

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Early and mid-term outcomes of concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery

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