Patient Care — Surgical therapy for atrial fibrillation

Atrial fibrillation afflicts nearly two million Americans. The
complications of atrial fibrillation include an elevated risk of stroke.
The symptoms include fatigue and shortness of breath. Moreover, AF
requires medical treatment often involving anticoagulation (blood
thinners) and antiarrhythmics (special medications to control heart rate
or rhythm). There are now minimally invasive, port access procedures
that have up to 85% success rates in curing AF. We offer a combined
approach, partnering with our EP cardiologists, using catheter-based as
well as thoracoscopic surgery to offer patients an option in treating
their AF.

Maze, Minimaze procedures:
The Cox maze procedure is a type of heart surgery for atrial fibrillation.

“Maze” refers to the series of incisions arranged in a maze-like pattern in the
atria. Today, various methods of minimally invasive maze procedures,
collectively named minimaze procedures, are used.

James Cox, MD, and associates developed the “maze” or “Cox maze” procedure, an
open-heart cardiac surgery procedure intended to eliminate atrial fibrillation
(AF), and performed the first one at St. Louis’ Barnes Hospital in 1987.

The intention was to eliminate AF by using
incisional scars to block abnormal electrical circuits (atrial macroreentry)
that AF requires. This required an extensive series of full-thickness incisions
through the walls of both atria, a median sternotomy (vertical incision through
the breastbone) and cardiopulmonary bypass (heart-lung machine; extracorporeal
circulation).

A series of improvements were made, culminating in 1992 in the Cox
maze III procedure, which is now considered to be the “gold standard” for
effective surgical cure of AF.