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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2018, Number 3

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Cir Card Mex 2018; 3 (3)

El istmo mitral: la clave del éxito en la cirugía de Cox-maze

García-Villarreal OA

Language: Spanish
References: 31
Page: 70-77
PDF size: 527.36 Kb.


ABSTRACT

The Cox-maze procedure has been designed in order to eliminate any type of atrial fibrillation or flutter. This is a surgical one that is compounded by a series of a surgical incisons or burn lines being stratrgically placed in order to avioid or even interrupt all possible macro- reentrant circuit or rotor in both atria. All this above thanks to a full bi-atrial lesion pattern. This is a non-focal approach. This is why this kind of procedure is highly effective in eliminating atrial fibrillation in one-go, in one-single step. Each of these lesions must be perfectly anchored on another previous lesion or on any of the valvular annuli. In addition, lesions must be placed all across the atrial myocardium before finishing themselves. The most critical one of all these is the one which is placed on the mitral isthmus. An improper performance in the mitral isthmus line may represent up to 20% in the failure rate after Cox-maze procedure. Cryolesion is the only highly effective alternative energy that can get a success rate as effective as 90% when applying on this area. We analyze some details in respect thereof herein.


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