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Does Surgical Ablation Energy Source Affect Long-Term Success of the Concomitant Cox Maze Procedure?

Thursday, June 29, 2017

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Source Name: The Annals of Thoracic Surgery


Niv Ad, Sari D. Holmes, Anthony J. Rongione, Paul S. Massimiano, Lisa M. Fornaresio

Ad and colleagues compared outcomes in patients receiving a Cox Maze (CM) procedure with cryothermal energy only or with cryothermal and bipolar radiofrequency, with 298 patients in each group. CM performed with either energy source proved safe and effective, with the authors evaluating perioperative outcomes, rhythm status, survival, and clinical events. Cryothermal ablation alone was associated with reduced perioperative stroke incidence and higher rates of sinus rhythm out to 60 months follow-up, findings that the authors highlight as important for future study.


Yes, that's very clear that there's no other better way to perform the Cox-maze procedure: 1) Bipolar RF ablation complemented with cryothermia over critical areas. 2) Cryothermia alone 2)Cut-and-sew complemented with cryothermia over critical areas ( CS, MV and TV annuli). What is surprising in this study is that Cryolesion was associated with reduced perioperative stroke rate at a 60 months follow-up. Briefly speaking, there's a widespread brief that Cryolesion is more thrombogenic than bipolar RF. Very interesting study. Congratulations to the authors! Ovidio

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