Cox-maze III procedure for atrial fibrillation. A preliminary study

Aim: To compare the efectiveness of the cut-and-sew Cox-maze III procedure against the Cox-maze IV peocedure by means of intraoperative bipolar radiofrequency delivery clamp. Material: From January 2011 to October 2014, 50 patients were operated on with surgery for atrial fibrillation. All cases underwent mitral valve surgery as the first procedure, and secondarily a surgical procedure for atrial fibrillation was also performed. There were 2 groups. Group I (Cox-maze III << cut-and-sew >>), and Group II (Cox-maze IV, intraoperative bipolar radiofrequency ablation). Group I was formed by 36 patients, and Group II by 14. All cases had atrial fibrillation longer than 1 year. The end-point was freedom of atrial fibrillation. Results: There was no statistically significant difference between both groups regarding the basal and operative characteristics. Operative mortality was of 2 cases in the Group I, and no cases for Group II (P = 0.9). A high tendency to eliminate atrial fibrillation in favour of Group I was observed (92% vs 53%, P < .001) in a 6 months follow-up. Conclusions: Classic standard Cox-maze III procedure showed superiority to eliminate atrial fibrillation over the Cox-maze IV procedure made with bipolar radiofrequency ablation clamp in patients with concomitant mitral valve disease. (C) 2016 Instituto Nacional de Cardiologia Ignacio Chavez. Published by Masson Doyma Mexico S.A.