JOURNAL ARTIC
LE
MID-TERM RESULTS OF THE
SURGICAL CORRECTION OF
HEADPHONE FIBRILATION WITH
THE CRYOMAZE PROCEDURE
THE MAZE CUTTING AND SEWING PROCEDURE
CONSISTS OF A SERIES OF DEFAULT INCISIONS AND
FOCAL CRIOLESIONS IN THE LEFT AND RIGHT
HEADPHONES
The surgical correction of atrial fibrillatios (AF) eas
first performed clinically in 1.987 by the Dr. James
Cox.
PATIENT AND
METHODS
SINCE JULY 2002 UNTIL
NOVEMBER 2005
119 patients underwent surgical correction of
AF with the CryoMaze procedure in two
Institutions.
All patients underwent preoperative
echocardiography to establish left atrial size,
left ventricular ejection performance and the
presence and extent of cardiac valve
dysfunction.
SURGICAL
TECHNIQUE
A COMPLETE LABYRINTH
OF THE RIGHT SIDE WAS
PERFORMED, WAS
ENTERED TO THE RIGHT
HEADPHONE WITH A
STANDARD COX INCISION
FROM THE IVC-SVC LINE
OBLIGUALLY UNTIL THE
RIGHT AV ROCK.
After aortic cross
restraint and cardioplegia
administration, the left
atrium was opened in the
interatrial groove and the
mitral valve and
pulmonary veins were
exposed.
C Á T E D R A: C AR D I O V AS C U L AR
THE MAZE PROCEDURE APPROVES THE
SYMPTOMS BY ESTABLISHING THE SINUSAL
RHYTHM, IMPROVES HEART PERFORMANCE BY
RESTORING AURICULOVENTRICULAR
SYNCHRONIZATION AND REDUCES THE RISK
OF THROMBOEMBOLISM
Early follow-up of the Maze procedure
performed with argon-driven cryoenergy
suggests safety and efficacy for the treatment
of AF.
SURGICAL
TECHNIQUE
A CRIOSONDA WITH ARGON
WAS USED TO CREATE ALL
INJURIES.
External right atrial lesions (lateral aspect of the
superior vena cava (SVC) to the inferior vena
cava (IVC) and a perpendicular lesion from the
first lesion to the right atrioventricular junction
(AV)
SURGICAL TECHNIQUR
THE LEFT HEADPHONE APPENDIX HOLE
OVERLINED WITH 3-0 OR 4-0
POLYPROPYLENE FROM INSIDE OR
EXTERNALLY, AFTER ALL STANDARD
CRIOLECTIONS WERE COMPLETED FROM
INSIDE THE LEFT HEADPHONE.
A CIRCUMFERENTIAL INJURY WAS
PERFORMED THAT SURROUNDED THE
PULMONARY VEINS AND CONNECTED THE
TWO END OF THE LEFT HEADSET INCISION
FOR 1 TO 1.5 MINUTES.
Then the connection lesions with the left
atrial appendage (1 minute) and the
middle portion of the posterior mitral ring
were performed (2 minutes: the isthmus
lesion)
 RESULTS FOLLOW-UP INTEGRITY
PATIENT POPULATION Among 96 live and available patients for heart rate
evaluation, 72 (75%) agreed to undergo continuous
ECG monitoring. The remaining 25% refused, but all
The average age of patients undergoing had ECG available for analysis.
CryoMaze AF correction was 64 years
(range, 18 to 86 years).
There were 39 women and 80 men.

KEY RESULTS POTENTIAL ADVANTAGES OF

CRIOENERGY
Cryothermia was the first source of energy used to directly
The key findings of this study include a low modify the heart's conduction system, both experimentally
and clinically, and is an integral part of the classic Maze
perioperative risk of CryoMaze AF sewing and cutting procedure
correction, a total absence of permanent
and late perioperative neurological events,
and a late absence (# 3 years) of AF in 85%
of patients with intermittent AF and slightly
less than 50% in patients with continuous
AF

1. The cryoenergy component of the classic

Maze procedure as in other surgical applications. CONCLUSION
2. In comparison to radiofrequency, cryotherapy
It is shown that the surgical correction of
is associated with a substantially lower volume of
CryoMaze AF is safe when performed alone or
endocardial thrombus and a relative preservation
in combination with other cardiac operations.
of tissue ultrastructure, including the endothelial
cell layer
3. The risk of collateral damage (ie esophageal
perforation) is less with the elimination of heat
compared to the addition of heat to the tissue.
4. Cryoadhesion increases the likelihood of a
contiguous injury.
5. Discrete transmural lesions are created
reliably with cryoenergy.
6. Cryoenergy is the only source of energy that
can safely create the critical isthmus lesion from
the surrounding pulmonary vein lesion to the
posterior mitral ring and cause electrical isolation
of the left atrium.

CONCLUSIONS
THIS STUDY INFORMS LONG-
TERM CLINICAL RESULTS
AND STATUS OF HEART RATE
CryoMaze AF correction is safe and is
associated with a very low risk of stroke. Few studies have reported long-term
Normal sinus rhythm rates more than 3 results of surgical correction of atrial
years after the operation were high for fibrillation (AF). We performed the set of
patients with intermittent AF and acceptable Cox-Maze III lesions with argon
for those with continuous AF. This cryoenergy (CryoMaze procedure) in all
experience supports a wider application of patients with AF who present for cardiac
CryoMaze to all patients with AF who need operations.
cardiac operations.

C Á T E D R A: C AR D I O V AS C U L AR