Abstract
The Cox-maze procedure has been considered the gold standard for the surgical treatment of atrial fibrillation since the 1990s. However, this procedure involves a very complex series of biatrial lesions predominantly made using a cut-and-sew technique. Because of the increased morbidity associated with this complex procedure, the Cox-maze procedure has not been widely adopted by cardiac surgeons. Since the development of alternative energy sources to replace the original cut-and-sew technique of the Cox-maze procedure, the maze procedure has become the standard surgical treatment for atrial fibrillation, particularly in cases where other cardiac operations must be performed (such as mitral valve repair). Recently, a radiofrequency bipolar clamp device has become popular due to its ease of use, speed and high rate of transmurality. Furthermore, some surgeons have modified the Cox-maze III procedure by eliminating certain lesions to simplify its complex lesion set. However, it remains unclear which lesions can be eliminated without decreasing the success rate of the operation. In this session, we will present current clinical outcomes of the maze procedure with different modalities, lesion sets, and indications from the literature review and the results of our own surgical series.
