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Journal of Cardiothoracic Surgery

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Open Access 01-12-2024 | Atrial Fibrillation | Review

Safety and efficacy of Cox‐Maze procedure for atrial fibrillation during mitral valve surgery: a meta-analysis of randomized controlled trials

Authors: Yaxuan Gao, Hanqing Luo, Rong Yang, Wei Xie, Yi Jiang, Dongjin Wang, Hailong Cao

Published in: Journal of Cardiothoracic Surgery | Issue 1/2024

Abstract

Background

Cox‐Maze procedure is currently the gold standard treatment for atrial fibrillation (AF). However, data on the effectiveness of the Cox‐Maze procedure after concomitant mitral valve surgery (MVS) are not well established. The aim of this study was to assess the safety and efficacy of Cox-Maze procedure versus no-maze procedure n in AF patients undergoing mitral valve surgery through a systematic review of the literature and meta‐analysis.

Methods

A systematic search on PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Clinical Trials (Cochrane Library, Issue 02, 2017) databases were performed using three databases from their inception to March 2023, identifying all relevant randomized controlled trials (RCTs) comparing Cox-Maze procedure versus no procedure in AF patients undergoing mitral valve surgery. Data were extracted and analyzed according to predefined clinical endpoints.

Results

Nine RCTs meeting the inclusion criteria were included in this systematic review with 663 patients in total (341 concomitant Cox‐Maze with MVS and 322 MVS alone). Across all studies with included AF patients undergoing MV surgery, the concomitant Cox‐Maze procedure was associated with significantly higher sinus rhythm rate at discharge, 6 months, and 12 months follow‐up when compared with the no-Maze group. Results indicated that there was no significant difference between the Cox‐Maze and no-Maze groups in terms of 1 year all-cause mortality, pacemaker implantation, stroke, and thromboembolism.

Conclusions

Our systematic review suggested that RCTs have demonstrated the addition of the Cox‐Maze procedure for AF leads to a significantly higher rate of sinus rhythm in mitral valve surgical patients, with no increase in the rates of mortality, pacemaker implantation, stroke, and thromboembolism.

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Title: Safety and efficacy of Cox‐Maze procedure for atrial fibrillation during mitral valve surgery: a meta-analysis of randomized controlled trials
Authors: Yaxuan Gao
Hanqing Luo
Rong Yang
Wei Xie
Yi Jiang
Dongjin Wang
Hailong Cao
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Atrial Fibrillation
Pacemaker
Pacemaker
Pacemaker
Published in: Journal of Cardiothoracic Surgery / Issue 1/2024
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-024-02622-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Safety and efficacy of Cox‐Maze procedure for atrial fibrillation during mitral valve surgery: a meta-analysis of randomized controlled trials

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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