HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hiroshi Okamoto Kenzo Yasuura Toshio Abe Mitsuya Murase Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Itoh, T. Articles by Murase, M. Search for Related Content PubMed PubMed Citation Articles by Itoh, T. Articles by Murase, M. Related Collections Related Articles

Ann Thorac Surg 1995;60:354-359
© 1995 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Left Atrial Function After Cox's Maze Operation Concomitant With Mitral Valve Operation

Departments of Thoracic Surgery, Yokkaichi Municipal Hospital, Yokkaichi, and Nagoya University School of Medicine, Nagoya, Japan

Accepted for publication February 20, 1995.

Background. This study examined whether the atrial fibrillation that commonly occurs in patients with a mitral valve operation could be eliminated by a concomitant maze operation.

Methods. Left atrial function after Cox's maze operation performed concomitantly with a mitral valve operation was evaluated in 10 patients ranging in age from 38 to 67 years (mean age, 54 years). Seven patients who had had coronary artery bypass grafting served as the control group. Using transthoracic echocardiography, the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) and the atrial filling fraction (AFF) were determined from transmitral flow measurements. These two indices have been considered to represent the contribution of left atrial active contraction to ventricular filling.

Results. The A/E ratio and the AFF were significantly lower in the maze group (0.35 +/- 0.17 versus 0.97 +/- 0.28 [p < 0.01] and 17.6% +/- 8.8% versus 36.8% +/- 6.4% [p < 0.01], respectively). The A/E ratio and the AFF correlated inversely with age (r = -0.72, p < 0.05 and r = 0.76, p < 0.05, respectively) in the maze group. In an angiographic study, the mean left atrial maximal volume index in the maze group was approximately three times larger than that in the control group (117.5 +/- 24.3 mL/m² versus 35.3 +/- 6.6 mL/m² [p < 0.01]). The left atrial active emptying volume index was significantly smaller in patients in the maze group (7.2 +/- 2.5 mL/m² versus 13.1 +/- 4.6 mL/m² [p < 0.01]).

Conclusions. After the maze procedure performed concomitantly with a mitral valve operation in patients with a dilated left atrium, left atrial contraction is detectable but incomplete in the elderly.

Related Articles

Invited Commentary

James L. Cox
Ann. Thorac. Surg. 1995 60: 359-360. [Extract] [Full Text]

This article has been cited by other articles:

				R. K. Voeller, A. Zierer, S. C. Lall, S.-i. Sakamoto, N.-L. Chang, R. B. Schuessler, M. R. Moon, and R. J. Damiano Jr. The effects of the Cox maze procedure on atrial function. J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1257 - 1264.e3. [Abstract] [Full Text] [PDF]

				J. W.W. Wong and K.-H. Mak Impact of Maze and Concomitant Mitral Valve Surgery on Clinical Outcomes Ann. Thorac. Surg., November 1, 2006; 82(5): 1938 - 1947. [Abstract] [Full Text] [PDF]

				W. Wisser, C. Khazen, E. Deviatko, G. Stix, T. Binder, R. Seitelberger, H. Schmidinger, and E. Wolner Microwave and radiofrequency ablation yield similar success rates for treatment of chronic atrial fibrillation Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 1011 - 1017. [Abstract] [Full Text] [PDF]

				S. Benussi, S. Nascimbene, E. Agricola, G. Calori, S. Calvi, A. Caldarola, M. Oppizzi, V. Casati, C. Pappone, and O. Alfieri Surgical ablation of atrial fibrillation using the epicardial radiofrequency approach: mid-term results and risk analysis Ann. Thorac. Surg., October 1, 2002; 74(4): 1050 - 1057. [Abstract] [Full Text] [PDF]

				E. P. Bauer, Z. A. Szalay, R. R. Brandt, H. F. Pitschner, G. Bachmann, H.-P. Brunner-La Rocca, and W. P. Klovekorn Predictors for atrial transport function after mini-maze operation Ann. Thorac. Surg., October 1, 2001; 72(4): 1251 - 1255. [Abstract] [Full Text] [PDF]

				H. B. Erdogan, G. Ipek, K. Kirali, S. N. Omeroglu, M. Guler, O. Isik, and C. Yakut Volume Reduction Procedures in Giant Left Atrium Asian Cardiovasc Thorac Ann, September 1, 2001; 9(3): 171 - 175. [Abstract] [Full Text] [PDF]

				S. Yuda, S. Nakatani, Y. Kosakai, M. Yamagishi, and K. Miyatake Long-term follow-up of atrial contraction after the maze procedure in patients with mitral valve disease J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1622 - 1627. [Abstract] [Full Text] [PDF]

				M. M. Scheinman Mechanisms of atrial fibrillation: is a cure at hand? J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1687 - 1692. [Abstract] [Full Text] [PDF]

				S. P. Thomas, G. R. Nunn, I. A. Nicholson, A. Rees, M. P. J. Daly, R. B. Chard, and D. L. Ross Mechanism, localization and cure of atrial arrhythmias occurring after a new intraoperative endocardial radiofrequency ablation procedure for atrial fibrillation J. Am. Coll. Cardiol., February 1, 2000; 35(2): 442 - 450. [Abstract] [Full Text] [PDF]

				M. Pasic, M. Musci, H. Siniawski, O. Grauhan, B. Edelmann, T. Tedoriya, Y. Weng, and R. Hetzer THE COX MAZE III PROCEDURE: PARALLEL NORMALIZATION OF SINUS NODE DYSFUNCTION, IMPROVEMENT OF ATRIAL FUNCTION, AND RECOVERY OF THE CARDIAC AUTONOMIC NERVOUS SYSTEM J. Thorac. Cardiovasc. Surg., August 1, 1999; 118(2): 287 - 296. [Abstract] [Full Text] [PDF]

				T. Nitta, R. Lee, R. B. Schuessler, J. P. Boineau, and J. L. Cox Radial approach: a new concept in surgical treatment for atrial fibrillation I. Concept, anatomic and physiologic bases and development of a procedure Ann. Thorac. Surg., January 1, 1999; 67(1): 27 - 35. [Abstract] [Full Text] [PDF]

				T. Nitta, R. Lee, H. Watanabe, K. M. Harris, J. M. Erikson, R. B. Schuessler, J. P. Boineau, and J. L. Cox Radial approach: a new concept in surgical treatment for atrial fibrillation. II. Electrophysiologic effects and atrial contribution to ventricular filling Ann. Thorac. Surg., January 1, 1999; 67(1): 36 - 50. [Abstract] [Full Text] [PDF]

				F. Isobe and Y. Kawashima The outcome and indications of the Cox maze III procedure for chronic atrial fibrillation with mitral valve disease J. Thorac. Cardiovasc. Surg., August 1, 1998; 116(2): 220 - 224. [Abstract] [Full Text] [PDF]

				J. Kamata, K. Kawazoe, H. Izumoto, H. Kitahara, Y. Shiina, Y. Sato, K. Nakai, T. Ohkubo, I. Tsuji, and K. Hiramori Predictors of Sinus Rhythm Restoration After Cox Maze Procedure Concomitant With Other Cardiac Operations Ann. Thorac. Surg., August 1, 1997; 64(2): 394 - 398. [Abstract] [Full Text]

				J. Kobayashi, Y. Kosakai, F. Isobe, Y. Sasako, K. Nakano, K. Eishi, and Y. Kawashima RATIONALE OF THE COX MAZE PROCEDURE FOR ATRIAL FIBRILLATION DURING REDO MITRAL VALVE OPERATIONS J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1216 - 1222. [Abstract] [Full Text]