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Long-Term Risk of Ischemic Stroke After the Cox-Maze III Procedure for Atrial Fibrillation
Conclusions This multicenter study showed a low incidence of perioperative and long-term postoperative ischemic stroke/TIA after CM-III. Although general risk of ischemic stroke/TIA was reduced, patients with CHA2DS2-VASc score 2 or greater had a higher risk compared with score 0 or 1. Complete left atrial appendage excision may be an important reason for the low ischemic stroke rate.
Source: The Annals of Thoracic Surgery - July 20, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Off-Pump Coronary Artery Bypass Reduces Early Stroke in Octogenarians: A Meta-Analysis of 18,000 Patients
Conclusions Coronary artery bypass in octogenarians can be performed safely with low early mortality. Although off-pump operations reduce the risk of early stroke, all other adverse events are comparable in on- and off-pump coronary artery bypass operations. Data regarding late mortality is at present limited; however, both on- and off-pump procedures appear to produce comparable survival.
Source: The Annals of Thoracic Surgery - March 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

A More Specific Anticoagulation Regimen Is Required for Patients After the Cox-Maze Procedure
Conclusions Our results indicate that the decision to discontinue OAC after the Cox-Maze procedure should not be based solely on CHADS2 scores; rather, rhythm status, echocardiographic findings, and patient risk for bleeding should be considered. These findings underscore the need for an OAC protocol for patients who have undergone the Cox-Maze procedure with appropriate LAA management.
Source: The Annals of Thoracic Surgery - October 12, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Should We Perform Carotid Doppler Screening Before Surgical or Transcatheter Aortic Valve Replacement?
Conclusions We found no statistically significant association between ICAS severity procedure-related stroke after aortic valve replacement. This suggests that universal carotid Doppler screening before isolated TAVR or SAVR is unnecessary.
Source: The Annals of Thoracic Surgery - October 4, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Late Neurologic Events After Surgery for Atrial Fibrillation: Rare but Relevant ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions After surgery for AF ablation, there is ongoing low risk of LNE even when the LAA is surgically excised. Further investigation should be pursued to clarify whether a difference exists with alternative elimination techniques and in patients in whom AF is successfully eliminated.
Source: The Annals of Thoracic Surgery - December 31, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Lee, R., Jivan, A., Kruse, J., McGee, E. C., Malaisrie, S. C., Bernstein, R., Lapin, B., Passman, R., Knight, B. P., McCarthy, P. M. Tags: Electrophysiology - arrhythmias ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

CHADS2 Score Predicts Postoperative Atrial Fibrillation in Patients Undergoing Elective Pulmonary Lobectomy
Conclusions Although multiple risk factors for PAF have been described, no easily applicable clinical model exists. Observed rate of PAF was significantly lower then the previously described 12% when CHADS2 was 0. CHADS2 can predict PAF in patients undergoing elective lobectomy and can identify patients to selectively institute prophylactic measures in patients at the greatest risk, such as patients with score of 2 or greater. Further validation of this model is warranted in a larger group.
Source: The Annals of Thoracic Surgery - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does Surgical Ablation Energy Source Affect Long-Term Success of the Concomitant Cox Maze Procedure?
Conclusions Concomitant CM procedures performed with cryothermal energy alone or combined with bipolar radiofrequency ablation are safe and exceedingly effective. The association of cryothermal energy alone with higher rates of sinus rhythm and stroke reduction should be investigated further.
Source: The Annals of Thoracic Surgery - June 17, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk of Intraatrial Thrombi After Thoracoscopic Ablation in Absence of Heparin and Appendage Closure
Conclusions Thoracoscopic ablation of AF can be associated with a risk of left atrial appendage thrombus formation and possibly also stroke. With administration of heparin during the ablation, followed by occlusion of the left atrial appendage as a part of the procedure, this risk can be effectively reduced.
Source: The Annals of Thoracic Surgery - August 25, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk factors for atrial fibrillation recurrence post Cox-maze IV performed without pre-exclusion
ConclusionsThe Cox maze IV procedure performed without pre-exclusions showed reasonable survival rates. Although AF recurred in patients with longer AFD, they fared well with significant increases in stroke volume. Concomitant atrial volume reduction may have contributed to these additional benefits.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early and Long-Term Mortality in 536 Patients After the Cox-Maze III Procedure: A National Registry-Based Study ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions Registry-based follow-up showed low early and long-term cardiovascular mortality and no stroke-related mortality. This is important baseline information when evaluating current surgical and nonsurgical treatment of atrial fibrillation.
Source: The Annals of Thoracic Surgery - April 30, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Albage, A., Jideus, L., Stahle, E., Johansson, B., Berglin, E. Tags: Electrophysiology - arrhythmias ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Impact of Atrial Fibrillation Duration on the Success of First-Time Concomitant Cox Maze Procedures
Conclusions Longer AF duration significantly impacted CM success and may result from extensive tissue remodeling. Patients with longer AF duration can expect reasonable success rates, especially when on AAD, and low stroke rates during follow-up. Cryoablation may reduce AF duration impact on success compared with combined bipolar radiofrequency and cryothermia.
Source: The Annals of Thoracic Surgery - July 27, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Root Replacement in Octogenarians Offers Acceptable Perioperative and Late Outcomes
Conclusions Octogenarians can safely undergo aortic root replacement with moderately worse but acceptable perioperative mortality and late survival. Further studies are necessary to determine which subset of octogenarians are at the highest operative risk and may benefit from a conservative approach.
Source: The Annals of Thoracic Surgery - October 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Follow-Up of Cardiac Rhythm in 320 Patients After the Cox-Maze III Procedure for Atrial Fibrillation
Conclusions In a single-moment electrocardiogram evaluation 9 years after the cut-and-sew CM-III, 82% of patients were in sinus rhythm or other regular supraventricular rhythm. These findings support a long-lasting positive effect of the CM-III procedure, which is relevant when evaluating current nonpharmacologic therapies for AF.
Source: The Annals of Thoracic Surgery - December 2, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Validation of the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Bleeding Severity Definition
Conclusions The E-CABG bleeding severity classification seems to be a valuable tool in the assessment of the severity and prognostic effect of perioperative bleeding in cardiac operations.
Source: The Annals of Thoracic Surgery - April 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Should We Ablate Atrial Fibrillation During Coronary Artery Bypass Grafting and Aortic Valve Replacement?
Conclusions Concomitant AF ablation in patients with AF undergoing CABG or AVR or both does not increase perioperative rates of mortality or morbidity. Moreover, concomitant AF ablation is effective at reducing postoperative AF burden and increases mid-term AF-free survival.
Source: The Annals of Thoracic Surgery - March 2, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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