5. Conclusions
This systematic review found that concomitant Cox-Maze in AF patients
undergoing MV surgery is associated with a strong tendency of better
mid-term freedom from AF when compared to PVI with comparable mid-term
postoperative survival outcomes. Large observational studies suggested
that there might be a mid-term survival benefit for patients undergoing
concomitant Cox-Maze procedure, although large multicenter RCT are still
needed to assess the long-term survival benefit of Cox-Maze procedure.
Successful intraoperative ablation of AF improves outcomes and thus the
ideal operation would correct both MV dysfunction and AF.
Ethical approval: Not directly applicable since this is a
review article.
Author contributions: DS: conceptualization, formal analysis,
investigation, methodology, validation, resources, writing – original
draft, critical revision and approval of the article. VT, SGR:
conceptualization, formal analysis, validation, resources, supervision,
writing – reviewing and editing, critical revision and approval of the
article. JH: conceptualization, formal analysis, validation, resources.
MT: validation, supervision, writing – reviewing and editing, critical
revision and approval of the article.