OBJECTIVE: The effects of the Cox maze procedure on atrial function remain poorly defined. The purpose of this study was to investigate the effects of a modified Cox maze procedure on left and right atrial function in a porcine model. METHODS: After cardiac magnetic resonance imaging, 6 pigs underwent pericardiotomy (sham group), and 6 pigs underwent a modified Cox maze procedure (maze group) with bipolar radiofrequency ablation. The maze group had preablation and immediate postablation left and right atrial pressure-volume relations measured with conductance catheters. All pigs survived for 30 days. Magnetic resonance imaging was then repeated for both groups, and conductance catheter measurements were repeated for the right atrium in the maze group. RESULTS: Both groups had significantly higher left atrial volumes postoperatively. Magnetic resonance imaging-derived reservoir and booster pump functional parameters were reduced postoperatively for both groups, but there was no difference in these parameters between the groups. The maze group had significantly higher reduction in the medial and lateral left atrial wall contraction postoperatively. There was no change in immediate left atrial elastance or in the early and 30-day right atrial elastance after the Cox maze procedure. Although the initial left atrial stiffness increased after ablation, right atrial diastolic stiffness did not change initially or at 30 days. CONCLUSIONS: Performing a pericardiotomy alone had a significant effect on atrial function that can be quantified by means of magnetic resonance imaging. The effects of the Cox maze procedure on left atrial function could only be detected by analyzing segmental wall motion. Understanding the precise physiologic effects of the Cox maze procedure on atrial function will help in developing less-damaging lesion sets for the surgical treatment of atrial fibrillation.
OBJECTIVE: The effects of the Cox maze procedure on atrial function remain poorly defined. The purpose of this study was to investigate the effects of a modified Cox maze procedure on left and right atrial function in a porcine model. METHODS: After cardiac magnetic resonance imaging, 6 pigs underwent pericardiotomy (sham group), and 6 pigs underwent a modified Cox maze procedure (maze group) with bipolar radiofrequency ablation. The maze group had preablation and immediate postablation left and right atrial pressure-volume relations measured with conductance catheters. All pigs survived for 30 days. Magnetic resonance imaging was then repeated for both groups, and conductance catheter measurements were repeated for the right atrium in the maze group. RESULTS: Both groups had significantly higher left atrial volumes postoperatively. Magnetic resonance imaging-derived reservoir and booster pump functional parameters were reduced postoperatively for both groups, but there was no difference in these parameters between the groups. The maze group had significantly higher reduction in the medial and lateral left atrial wall contraction postoperatively. There was no change in immediate left atrial elastance or in the early and 30-day right atrial elastance after the Cox maze procedure. Although the initial left atrial stiffness increased after ablation, right atrial diastolic stiffness did not change initially or at 30 days. CONCLUSIONS: Performing a pericardiotomy alone had a significant effect on atrial function that can be quantified by means of magnetic resonance imaging. The effects of the Cox maze procedure on left atrial function could only be detected by analyzing segmental wall motion. Understanding the precise physiologic effects of the Cox maze procedure on atrial function will help in developing less-damaging lesion sets for the surgical treatment of atrial fibrillation.
Authors: Sydney L Gaynor; Hersh S Maniar; Sunil M Prasad; Paul Steendijk; Marc R Moon Journal: Am J Physiol Heart Circ Physiol Date: 2004-12-09 Impact factor: 4.733
Authors: Jennifer E Cummings; Antonio Pacifico; John L Drago; Fethi Kilicaslan; Andrea Natale Journal: Pacing Clin Electrophysiol Date: 2005-05 Impact factor: 1.976
Authors: Spencer J Melby; Sydney L Gaynor; Jordon G Lubahn; Anson M Lee; Paymon Rahgozar; Shelton D Caruthers; Todd A Williams; Richard B Schuessler; Ralph J Damiano Journal: J Thorac Cardiovasc Surg Date: 2006-10 Impact factor: 5.209
Authors: Spencer J Melby; Andreas Zierer; Marci S Bailey; James L Cox; Jennifer S Lawton; Nabil Munfakh; Traves D Crabtree; Nader Moazami; Charles B Huddleston; Marc R Moon; Ralph J Damiano Journal: Ann Surg Date: 2006-10 Impact factor: 12.969
Authors: A Albirini; G M Scalia; R D Murray; M K Chung; P M McCarthy; B P Griffin; K L Arheart; A L Klein Journal: J Am Soc Echocardiogr Date: 1997 Nov-Dec Impact factor: 5.251
Authors: Sydney L Gaynor; Richard B Schuessler; Marci S Bailey; Yosuke Ishii; John P Boineau; Marye J Gleva; James L Cox; Ralph J Damiano Journal: J Thorac Cardiovasc Surg Date: 2005-01 Impact factor: 5.209
Authors: Timo Weimar; Yoshiyuki Watanabe; Toshinobu Kazui; Urvi S Lee; Marc R Moon; Richard B Schuessler; Ralph J Damiano Journal: Am J Physiol Heart Circ Physiol Date: 2012-04-13 Impact factor: 4.733
Authors: Rochus K Voeller; Abdulhameed Aziz; Hersh S Maniar; Nneka N Ufere; Ajay K Taggar; Noel J Bernabe; Brian P Cupps; Marc R Moon Journal: Am J Physiol Heart Circ Physiol Date: 2011-09-16 Impact factor: 4.733
Authors: Toshinobu Kazui; Mathew C Henn; Yoshiyuki Watanabe; Sándor J Kovács; Christopher P Lawrance; Jason W Greenberg; Marc Moon; Richard B Schuessler; Ralph J Damiano Journal: J Thorac Cardiovasc Surg Date: 2015-09-05 Impact factor: 5.209
Authors: Jason O Robertson; Anson M Lee; Rochus K Voeller; Marci S Damiano; Richard B Schuessler; Ralph J Damiano Journal: Eur J Cardiothorac Surg Date: 2014-02-11 Impact factor: 4.191
Authors: Shoichi Okada; Timo Weimar; Marc R Moon; Richard B Schuessler; Laurie A Sinn; Ralph J Damiano; Hersh S Maniar Journal: Ann Thorac Surg Date: 2013-08-02 Impact factor: 4.330