Any cardiac surgeons out there? We know many of you may have been wondering if the typical Cox-maze procedure could be improved upon, and today’s your lucky day.
A team from the Washington University School of Medicine has shown that changing the typical pattern of lesions in the Cox-maze procedure into a box formation improves outcomes in a whole bunch of boring statistical ways:
From the abstract in the Journal of Thoracic and Cardiac Surgery:
The incidence of early atrial tachyarrhythmia was significantly higher in the single connecting lesion group compared with that in the box lesion group (71% vs 37%, P < .001). The overall freedom from atrial fibrillation recurrence was significantly higher in the box lesion group at 1 (87% vs 69%, P = .015) and 3 (96% vs 85%, P = .028) months. The use of antiarrhythmic drugs was significantly lower in the box lesion group at 3 (35% vs 58%, P = .018) and 6 (15% vs 44%, P = .002) months.
We notice one glaring omission. The authors refer to creating a “box” lesion in the “Cox-maze” procedure…but nowhere do they attempt to introduce the term “Cox-Box”.
More from the Washington University School of Medicine
Abstract: Isolating the entire posterior left atrium improves surgical outcomes after the Cox maze procedure …