NationMaster - Encyclopedia: Maze procedure

The maze procedure is a collection of cardiac surgery procedures intended to cure atrial fibrillation (AF), a common disturbance of heart rhythm. Recently, various methods of minimally invasive maze procedures have been developed; these procedures are collectively named minimaze - "mini" versions of the original maze surgery. Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ...

The Cox maze procedure

James Cox, MD, and associates developed the "maze" or "Cox maze" procedure, an "open-heart" cardiac surgery procedure intended to eliminate atrial fibrillation, and performed the first one in 1987.^[1] “Maze” refers to the series of incisions arranged in a maze-like pattern in the atria. The intention was to eliminate AF by using incisional scars to block abnormal electrical circuits (atrial macroreentry) that AF requires. This required an extensive series of endocardial (from the inside of the heart) incisions through both atria, a median sternotomy (vertical incision through the breastbone) and cardiopulmonary bypass (heart-lung machine; extracorporeal circulation). A series of improvements were made, culminating in 1992 in the Cox maze III procedure, which is now considered to be the "gold standard” for effective surgical cure of AF. It was quite successful in eliminating AF, but had drawbacks as well.^[2] The Cox maze III is sometimes referred to as the “Traditional maze”, the “cut and sew maze”, or simply the "maze". Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... Atria may refer to: Atria is an alternative spelling for the Etruscan city that is now Adria in the Veneto region of Northern Italy. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... In the heart, the endocardium is the innermost layer of tissue that lines the chambers of the heart. ... Extracorporeal circulation refers to pumping of blood in a circuit outside the body. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF...

Efforts have since been made to equal the success of the Cox maze III while reducing surgical complexity and likelihood of complications. During the late 1990s, operations similar to the Cox maze, but with fewer atrial incisions, led to the use of the terms "minimaze", "mini maze" and “mini-maze”,^[3] although these were still major operations. In anatomy, the atrium (plural: atria) is the blood collection chamber of a heart. ...

A primary goal has been to perform a curative, "maze-like" procedure epicardially (from the outside of the heart), so that it could be performed on a normally beating heart, without cardiopulmonary bypass. Until recently this was not thought possible; as recently as 2004, Dr. Cox defined the mini-maze as requiring an endocardial approach: In the heart, the endocardium is the innermost layer of tissue that lines the chambers of the heart. ...

Minimally invasive epicardial surgical procedures for AF (minimaze)

Although Dr. Cox's 2004 definition specifically excludes an epicardial approach to eliminate AF, he and others pursued this important goal, and the meaning of the term changed as successful epicardial procedures were developed. In 2002 Saltman performed a completely endoscopic surgical ablation of AF^[5] and subsequently published their results in 14 patients.^[6] These were performed epicardially, on the beating heart, without cardiopulmonary bypass or median sternotomy. Their method came to be known as the minimaze or microwave minimaze procedure, because microwave energy was used to make the lesions that had previously been performed by the surgeon's scalpel. AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Endoscopy means looking inside and refers to looking inside the human body for medical reasons. ... Ablation is defined as the removal of material from the surface of an object by vaporization, chipping, or other erosive processes. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Microwave Slang for small waves, like at a beach, often used by surfers. ...

Shortly thereafter, Randall K. Wolf, MD and others developed a procedure using radiofrequency energy rather than microwave, and different, slightly larger incisions. In 2005, he published his results in the first 27 patients.^[7] This came to be known as the Wolf minimaze procedure. Radio frequency, or RF, refers to that portion of the electromagnetic spectrum in which electromagnetic waves can be generated by alternating current fed to an antenna. ...

Today, the terms “minimaze”, "mini-maze", and "mini maze" are still sometimes used to describe open heart procedures requiring cardiopulmonary bypass and median sternotomy, but are more commonly they refer to minimally invasive, epicardial procedures not requiring cardiopulmonary bypass, such as those developed by Saltman, Wolf, and others. These procedures are characterized by:

Microwave minimaze

Completely Endoscopic Microwave Ablation of Atrial Fibrillation on the Beating Heart Using Bilateral Thoracoscopy: The microwave minimaze requires three 5 mm to 1cm incisions on each side of the chest for the surgical tools and the endoscope. The pericardium is entered, and two sterile rubber tubes are threaded behind the heart, in the transverse and oblique sinuses. These tubes are joined together, then used to guide the flexible microwave antenna energy source through the sinuses behind the heart, to position it for ablation. Energy is delivered and the atrial tissue heated and destroyed in a series of steps as the microwave antenna is withdrawn behind the heart. The lesions form a "box-like" pattern around all four pulmonary veins behind the heart. The left atrial appendage is usually removed.^[5]^[6] A very thorough description of the procedure is available. Endoscopy means looking inside and refers to looking inside the human body for medical reasons. ... The pericardium is a double-walled sac that contains the heart and the roots of the great vessels. ... Microwaves are electromagnetic waves with wavelengths longer than those of terahertz (THz) frequencies, but relatively short for radio waves. ... Ablation is defined as the removal of material from the surface of an object by vaporization, chipping, or other erosive processes. ... In anatomy, the atrium (plural: atria) is the blood collection chamber of a heart. ... Microwaves are electromagnetic waves with wavelengths longer than those of terahertz (THz) frequencies, but relatively short for radio waves. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ...

Wolf minimaze

Video-assisted Bilateral Epicardial Bipolar Radiofrequency Pulmonary Vein Isolation and Left Atrial Appendage Excision: The Wolf minimaze requires one 5cm and two 1cm incisions on each side of the chest. These incisions allow the surgeon to maneuver the tools, view areas through an endoscope, and to see the heart directly. The right side of the left atrium is exposed first. A clamp-like tool is positioned on the left atriumnear the right pulmonary veins, and the atrial tissue is heated between the jaws of the clamp, cauterizing the area. The clamp is removed. The autonomic nerves (ganglionated plexi) that may cause AF^[8] may be eliminated as well. Subsequently the left side of the chest is entered. The ligament of Marshall (a vestigial structure with marked autonomic activity) is removed. The clamp is subsequently positioned on the left atrium near the left pulmonary veins for ablation. Direct testing to demonstrate complete electrical isolation of the pulmonary veins, and that the ganglionated plexi are no longer active, may be performed.^[7] Endoscopy means looking inside and refers to looking inside the human body for medical reasons. ... In Anatomy, atrium refers to a structure of the heart. ... In Anatomy, atrium refers to a structure of the heart. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ... In anatomy, the atrium (plural: atria) is the blood collection chamber of a heart. ... Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating energy needed to cope with stressful... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating energy needed to cope with stressful... In Anatomy, atrium refers to a structure of the heart. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ... Ablation is defined as the removal of material from the surface of an object by vaporization, chipping, or other erosive processes. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ...

High Intensity Focused Ultrasound (HIFU) minimaze

Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: Although the HIFU minimaze is performed epicardially, on the normally beating heart, it is also usually performed in conjunction with other cardiac surgery, and so would not be minimally invasive in those cases. An ultrasonic device is positioned epicardially, on the left atrium, around the pulmonary veins, and intense acoustic energy is directed at the atrium to destroy tissue in the appropriate regions near the pulmonary veins.^[9] // HIFU (high intensity focused ultrasound) (sometimes FUS or HIFUS) is a highly precise medical procedure using high-intensity focused ultrasound to heat and destroy pathogenic tissue rapidly. ... Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... Ultrasound is sound with a frequency greater than the upper limit of human hearing, approximately 20 kilohertz. ... In Anatomy, atrium refers to a structure of the heart. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ... In Anatomy, atrium refers to a structure of the heart. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ...

Mechanism of Elimination of Atrial Fibrillation

The mechanism by which AF is eliminated by curative procedures such as the maze, minimaze, or catheter ablation is controversial. All successful methods destroy tissue in the areas of the left atrium near the junction of the pulmonary veins, hence these regions are thought to be important. A concept gaining support is that paroxysmal AF is mediated in part by the autonomic nervous system ^[8] and that the intrinsic cardiac nervous system, which is located in these regions, plays an important role.^[10] Supporting this is the finding that targeting these autonomic sites improves the likelihood of successful elimination of AF by catheter ablation.^[11]^[12] AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Catheter ablation is an invasive procedure used to remove a faulty electrical pathway from the hearts of those who are prone to developing cardiac arrhythmias such as supraventricular tachycardias (SVT) and Wolff-Parkinson-White syndrome. ... In Anatomy, atrium refers to a structure of the heart. ... The pulmonary veins carry blood from the lungs to the left atrium of the heart. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... This article or section is in need of attention from an expert on the subject. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Catheter ablation is an invasive procedure used to remove a faulty electrical pathway from the hearts of those who are prone to developing cardiac arrhythmias such as supraventricular tachycardias (SVT) and Wolff-Parkinson-White syndrome. ...

Patient Selection

The minimaze procedures are alternatives to catheter ablation of AF, and the patient selection criteria are similar. Patients are considered for minimaze procedures if they have moderate or severe symptoms and have failed medical therapy; asymptomatic patients are generally not considered. Those most likely to have a good outcome have paroxysmal (intermittent) AF, and have a heart that is relatively normal. Those with severely enlarged atria, marked cardiomyopathy, or severely leaking heart valves are less likely to have a successful result; these procedures are generally not recommended for such patients. Previous cardiac surgery provides technical challenges due to scarring on the outside of the heart, but does not always preclude minimaze surgery. Catheter ablation is an invasive procedure used to remove a faulty electrical pathway from the hearts of those who are prone to developing cardiac arrhythmias such as supraventricular tachycardias (SVT) and Wolff-Parkinson-White syndrome. ... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... AF may stand for: Afghanistan (ISO 3166-1 alpha-2, AF) Afrikaans language (ISO 639 alpha-2, af) audio frequency acre-foot Acronym Finder air force Air France Alliance Française armed forces Astoria Financial Corporation (stock symbol) atrial fibrillation automatic focus Alabama and Florida Railway (AAR reporting mark AF... Atria may refer to: Atria is an alternative spelling for the Etruscan city that is now Adria in the Veneto region of Northern Italy. ... In anatomy, the heart valves are valves in the heart that prevent blood from flowing the wrong way. ... Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ...

Surgical Results

Long-term success of the minimaze procedures awaits a consensus. Attaining a consensus is hindered by several problems; perhaps the most important of these is incomplete or inconsistent post-procedure follow-up to determine if atrial fibrillation has recurred.^[2] It has been clearly demonstrated that longer or more intensive follow-up identifies much more recurrent atrial fibrillation,^[13] hence a procedure with more careful follow-up will appear to be less successful. In addition, procedures continue to evolve rapidly, so long follow-up data do not accurately reflect current procedural methods. For more recent minimaze procedures, only relatively small and preliminary reports are available. A new metric ("Single Procedure Risk Adjusted Success") has been proposed in an attempt to control for some of these inconsistencies, but it has not been widely accepted. With those caveats in mind, it can be said that reported short-term success rates range from 67% to 91%.^[6]^[7]^[9] Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ...

References

A more complete current listing of minimaze references can be obtained by this search at the Cardiothoracic Surgery Network. The Cardiothoracic Surgery Network (CTSNet) is a worldwide organization with a mandate to be a source of educational and scientific research information for cardiothoracic surgeons. ...

^ Cox J, Schuessler R, D'Agostino H, Stone C, Chang B, Cain M, Corr P, Boineau J (1991). "The surgical treatment of atrial fibrillation. III. Development of a definitive surgical procedure.". J Thorac Cardiovasc Surg 101 (4): 569-83. PMID 2008095.
^ ^a ^b Prasad S, Maniar H, Camillo C, Schuessler R, Boineau J, Sundt T, Cox J, Damiano R (2003). "The Cox maze III procedure for atrial fibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures.". J Thorac Cardiovasc Surg 126 (6): 1822-8. PMID 14688693.
^ Szalay Z, Skwara W, Pitschner H, Faude I, Klövekorn W, Bauer E (1999). "Midterm results after the mini-maze procedure.". Eur J Cardiothorac Surg 16 (3): 306-11. PMID 10554849.
^ Cox J (2004). "The role of surgical intervention in the management of atrial fibrillation.". Tex Heart Inst J 31 (3): 257-65. PMID 15562846.
^ ^a ^b Saltman A, Rosenthal L, Francalancia N, Lahey S (2003). "A completely endoscopic approach to microwave ablation for atrial fibrillation.". Heart Surg Forum 6 (3): E38-41. PMID 12821436.
^ ^a ^b ^c Salenger R, Lahey S, Saltman A (2004). "The completely endoscopic treatment of atrial fibrillation: report on the first 14 patients with early results.". Heart Surg Forum 7 (6): E555-8. PMID 15769685.
^ ^a ^b ^c Wolf R, Schneeberger E, Osterday R, Miller D, Merrill W, Flege J, Gillinov A (2005). "Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation.". J Thorac Cardiovasc Surg 130 (3): 797-802. PMID 16153931.
^ ^a ^b Coumel P. "Paroxysmal atrial fibrillation: a disorder of autonomic tone?". Eur Heart J 15 Suppl A: 9-16. PMID 8070496.
^ ^a ^b Ninet J, Roques X, Seitelberger R, Deville C, Pomar J, Robin J, Jegaden O, Wellens F, Wolner E, Vedrinne C, Gottardi R, Orrit J, Billes M, Hoffmann D, Cox J, Champsaur G (2005). "Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: results of a multicenter trial.". J Thorac Cardiovasc Surg 130 (3): 803-9. PMID 16153932.
^ Scherlag B, Po S (2006). "The intrinsic cardiac nervous system and atrial fibrillation.". Curr Opin Cardiol 21 (1): 51-4. PMID 16355030.
^ Pappone C, Santinelli V, Manguso F, Vicedomini G, Gugliotta F, Augello G, Mazzone P, Tortoriello V, Landoni G, Zangrillo A, Lang C, Tomita T, Mesas C, Mastella E, Alfieri O (2004). "Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation.". Circulation 109 (3): 327-34. PMID 14707026.
^ Scherlag B, Nakagawa H, Jackman W, Yamanashi W, Patterson E, Po S, Lazzara R (2005). "Electrical stimulation to identify neural elements on the heart: their role in atrial fibrillation.". J Interv Card Electrophysiol 13 Suppl 1: 37-42. PMID 16133854.
^ Israel C, Grönefeld G, Ehrlich J, Li Y, Hohnloser S (2004). "Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device: implications for optimal patient care.". J Am Coll Cardiol 43 (1): 47-52. PMID 14715182.

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Health Science – Medicine - Surgery - Cardiac surgery

Surgeries/Surgical diseases of the aorta
Aortic aneurysm, Aortic dissection, Bentall procedure, David procedure, Marfan syndrome Health sciences are the group of disciplines of applied science dealing with human and animal health. ... medicines, see medication and pharmacology. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... The aorta (generally pronounced or ay-orta) is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation. ... An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. ... Aortic dissection is a tear in the wall of the aorta (the largest artery of the body). ... A Bentall procedure is a cardiac surgery operation involving composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. ... Valve-sparing aortic root replacement (also known as the David procedure) is a cardiac surgery procedure involving replacement of the ascending aorta without replacement of the aortic valve. ... This does not cite its references or sources. ...

Valvular Heart Disease
Aortic valve repair, Aortic valve replacement, Ross procedure, Mitral valve repair, Mitral valve replacement, Tricuspid valve repair, Tricuspid valve replacement Wikipedia does not yet have an article with this exact name. ... Aortic valve repair is a surgical procedure used to correct some aortic valve disorders. ... The aortic valve is one of the valves of the heart. ... The Ross procedure (or pulmonary autograft) is a cardiac surgery operation where a diseased aortic valve is replaced with the persons own pulmonary valve. ... Mitral valve repair involves the replacement of stenified vitrious fibres that have frayed off of the wall of the duct. ... Mitral valve replacement is a cardiac surgery procedure in which a patients mitral valve is replaced by a different valve. ...

Surgeries/Surgical diseases of the myocardium
Coronary artery bypass surgery, Ischemic VSD, Maze procedure, Septal myectomy, Ventricular reduction Myocardium is the muscular tissue of the heart. ... Early in a coronary artery bypass surgery during vein harvesting from the legs (left of image) and the establishment of bypass (placement of the aortic cannula) (bottom of image). ... A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). ... Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). ... Ventricular reduction is a type of operation in cardiac surgery to reduce enlargement of the heart from cardiomyopathy or ischemic aneurysm formation. ...

Heart transplantation
Ischemic cardiomyopathy, Hypertrophic cardiomyopathy, Ventricular assist device Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium. ... Hypertrophic cardiomyopathy, or HCM, is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. ... A Ventricular assist device, or VAD, is mechanical device that is used to partially or completely replace the function of a failing heart. ...

Congenital heart disease
Atrial septal defect, Ebstein's anomaly, Pulmonary stenosis, Tetralogy of Fallot, Transposition of the great arteries, Ventricular septal defect Cross-section of a healthy heart. ... Atrial septal defects (ASD) are a group of congenital heart diseases that enables communication between atria of the heart and may involve the interatrial septum. ... Ebsteins anomaly is a congenital heart defect in which the opening of the tricuspid valve is displaced towards the apex of the right ventricle of the heart. ... Pulmonary stenosis is a congenital medical condition in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. ... The tetralogy of Fallot is a congenital heart defect which classically has four anatomical components. ... Transposition of the Great Arteries (TGA), also referred to as Transposition of the Great Vessels (TGV), is a cyanotic congenital heart defect (CHD), in which the primary arteries of the heart (the aorta and the pulmonary artery) are transposed. ... A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). ...

Contents

The Cox maze procedure

Minimally invasive epicardial surgical procedures for AF (minimaze)

Microwave minimaze

Wolf minimaze

High Intensity Focused Ultrasound (HIFU) minimaze

Mechanism of Elimination of Atrial Fibrillation

Patient Selection

Surgical Results

References

External links

Contents

The Cox maze procedure GA_googleFillSlot("encyclopedia_square");

Minimally invasive epicardial surgical procedures for AF (minimaze)

Microwave minimaze

Wolf minimaze

High Intensity Focused Ultrasound (HIFU) minimaze

Mechanism of Elimination of Atrial Fibrillation

Patient Selection

Surgical Results

References

External links

The Cox maze procedure