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Cut and Sew Cox-Maze III Procedure With Mexican Modification

Tuesday, November 22, 2016

This video demonstrates a Mexican modification to the traditional Maze III procedure, which was initially described by Dr. James Cox. This technique is ideal for patients with mitral valve disease and atrial fibrillation who are undergoing surgery. This modification allows the surgeon to better control the base of the left atrial appendage and the surrounding area, as well as perform the mitral valve procedure more easily. The author has performed this technique in over 50 cases.


Dear Professor, I want to congratulate you for the video that shows here. The proposed modification is reproducible and I believe it is safe to repair and thus prevent bleeding in the posterior portion of the heart.
Dear Danny, many thanks for your expert comments. The idea is to promote this procedures in order to encourage cardiac surgeons performing COMPLETE surgical procedures, talking about MV surgery with concomitant AF.
Congratulations Dr. Garcia-Villarreal for this very clear video. This is without any doubt the most reliable way to achieve long term freedom from atrial fibrillation/flutter even in the setting of advanced structural heart disease. The remaining Cox-Maze IV options are good strategies but still inferior to this Gold Standard. They still risk incomplete transmurality and recurrences. Thank you for your contribution.
Dear Dr. Eduard Quintana, Thank you so much for your nice and expert comments. I fully agree with your point of view regarding the effectiveness of this procedure here. And you mentioned the key part of this dilemma. While it is not bipolar radiofrequency or cryolesion, the procedure becomes less effective. I share your opinion, the gold standard is still the "cut-and-sew" in a full biatrial pattern. Here didn't use cryolesión because I do not have cryoprobe here in Mexico. The reason why cardiac surgeons do not currently use the Cox-maze III "cut-and-sew" is because of its complexity. However, here it has been demonstrated that it is possible to use it safely and effectively, especially in cases of MV and AF. Thank you so much for your fine comments. Greetings to all of you in Hospital Clinic de Barcelona.
Congratulations Dr Garcia Villareal . Very nice operation. What is the average of cross clamping time during the procedure in your experience? Thank you in advance.
Many thanks, Ricardo. On average, two hours, mitral valve procedure included. Longer than usual, but this is the most effective method to cure chronic AF, especially in MV surgery. Thank you for your comments.

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