J Med Assoc Thai 2002; 85 (11):1182

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Modified Cox Maze Procedure for Atrial Fibrillation with Mitral Valve Disease
Ngodngamthaweesuk M Mail, Boonkasem S , Subhannachart W , Attanawanich S , Supakul V , Masnaragorn P

SOMBOON BOONKASEM, M.D.*,
SUKASOM ATTANAWANICH, M.D.*,
PORNPIMOL MASNARAGORN, R.N.**
Objective
: To determine early term results of the modified Cox maze procedure for curing
atrial fibrillation (AF) associated with mitral valve disease.
Method
: Between January and December 2000, 10 consecutive patients with AF underwent
the modified Cox maze procedure with mitral valve repair in 2 and replacement in 8. The associated
procedure included 3 aortic valve replacements, 1 tricuspid annuloplasty, and 2 atrial septal defect
closures.
There were 5 males and 5 females, with ages ranging from 19 to 52 years (mean
=
38.3
years).
Pre-operative-existing AF time varied from 4 to 146 months (mean
=
41.1 months), and left
atrial dimension varied from 4.50 to 6.89 em (mean 5.51 em).
The authors modified the maze atriotomies to preserve the sinus node artery and used cryo-
ablation, incision and suture to simplify the procedures.
Results
: Seven cases (70%) regained sinus rhythm and 3 cases (30%) still remained in AF.
Two cases (double valve replacement) needed intraaortic balloon pump.
Two of them developed cardiac tamponade I month post-operatively, (one in sinus rhythm
case and another one in AF).
Those 3 patients who remained in AF had a longer pre-operative existing AF-time and larger
left atrial dimension but it was insignificant (p
=
0.227 and p
=
0.187 respectively). There was no early
or late mortality.
Vol. 85 No. 11
COX MAZE FOR ATRIAL FIBRILLATION
1183
Conclusion : The pertaining results suggest that the modified Cox maze procedure has satis-
factory effectiveness to cure atrial fibrillation, restore atrioventricular synchrony and preserve atrial
transport function in the patients having AF associated with mitral valve disease.
Key word : Atrial Fibrillation, Cox Maze Procedure, Mitral Valve Disease

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