The Cox maze III procedure for atrial fibrillation: Long-term efficacy in patients undergoing lone versus concomitant procedures
The Cox maze III procedure for atrial fibrillation: Long-term efficacy in patients undergoing lone versus concomitant procedures
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DOI：
10.1016/s0022-5223(03)01287-x
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发表时间：
2003-12-01
影响因子：
6
通讯作者：
Damiano, RJ
中科院分区：
文献类型：
--
作者：
Prasad, SM;Maniar, HS;Damiano, RJ
背景：在过去的十年中，考克斯迷宫III手术已用于治疗房颤。目前尚不清楚该手术对孤立性房颤患者的疗效是否与冠状动脉、瓣膜或先天性心脏病相关房颤患者相似。本研究探讨了长期的结果，患者谁经历了这个过程无论是作为一个单独的操作或作为一个伴随procedure.Methods：从1988年至2001年，198例患者进行了考克斯迷宫III程序; 112个是单独的操作，86个是伴随程序。主要并发症包括肾功能衰竭、出血再手术、纵隔炎、卒中和球囊泵插入。通过邮件和电话问卷的方式对患者及其心脏病专家进行随访。所有有心律失常病史或正在服用药物的患者均通过心电图记录其心律。结果：单独手术组明显年轻（51.3 +/- 10.5 vs 58.8 +/- 9.9岁），男性/女性比例较高（4：1 vs 2：1）。两组的手术死亡率无差异（1.8% vs 1.2%）。在5.4 ± 2.9年的随访中，96.6%（172/178）的患者无房颤。结论：考克斯迷宫III术在单纯手术和同期手术患者中具有相同的手术风险和远期疗效。考克斯迷宫III手术仍然是判断房颤替代手术的标准。
Background: For the last decade, the Cox maze III procedure has been available for the treatment of atrial fibrillation. It is unknown whether the operation has similar efficacy in patients with lone atrial fibrillation compared with that in patients with atrial fibrillation associated with coronary, valve, or congenital heart disease. This study examined the long-term outcome of patients who underwent this procedure either as a lone operation or as a concomitant procedure.Methods: From 1988 to 2001, 198 patients underwent a Cox maze III procedure; 112 were lone operations, and 86 were concomitant procedures. Major complications included renal failure, reoperation for bleeding, mediastinitis, stroke, and balloon pump insertion. Follow-up was performed by means of mail and telephone questionnaires with both the patients and their cardiologists. All patients who had any history of arrhythmia or who were taking medication had their rhythm documented by means of electrocardiography.Results: The lone operation group was significantly younger (51.3 +/- 10.5 vs 58.8 +/- 9.9 years) and had a higher male/female ratio (4:1 vs 2:1). There was no difference in operative mortality between groups (1.8% vs 1.2%). At a follow-up of 5.4 +/- 2.9 years, 96.6% (172/178) of all patients were free of atrial fibrillation. There was no difference between the lone operation and concomitant procedure groups (95.9% vs 97.5%).Conclusion: The Cox maze III procedure has equivalent operative risk and long-term efficacy in patients undergoing both lone operations and concomitant procedures. The Cox maze III procedure remains the standard against which alternative procedures for atrial fibrillation must be judged.