Takahashi Shinya, Sueda Taijiro
Department of Cardiovascular Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Gen Thorac Cardiovasc Surg. 2017 Mar;65(3):144-152. doi: 10.1007/s11748-016-0728-y. Epub 2016 Nov 16.
The Cox-Maze procedure is the most popular surgical procedure in the world for eliminating atrial fibrillation (AF). Japanese surgeons performed and modified its procedure. This review describes the concept of the Maze procedure, modifications of the Maze procedure and findings related to the Maze procedure obtained by Japanese surgeons.
Original Cox-Maze procedures and modified Maze procedures developed by Japanese surgeons were reviewed chronologically.
Japanese surgeons modified Cox-Maze II and III procedures, including Kosakai-Maze procedure, Cryo-Maze procedure, the Radial approach and the left atrial Maze procedure, and there were many midterm and long-term clinical results of the original and modified Maze procedures especially for AF associated with mitral valve disease. These modifications may be possible to elucidate the mechanism of paroxysmal AF. The mechanism of persistent AF is presumed to be multiple reentry based on the success of surgical approaches as well as electrophysiological study.
Japanese surgeons have modified and simplified the Maze procedure, and have improved the Maze procedure as well as helped to clarify the mechanisms of AF.
考克斯迷宫手术是全球最常用的消除心房颤动（房颤）的外科手术。日本外科医生实施并改进了该手术。本文综述了迷宫手术的概念、迷宫手术的改进以及日本外科医生在迷宫手术方面的研究成果。
按时间顺序回顾了日本外科医生开发的原始考克斯迷宫手术及改良迷宫手术。
日本外科医生对考克斯迷宫II和III手术进行了改良，包括小坂迷宫手术、冷冻迷宫手术、放射状入路和左心房迷宫手术，原始和改良迷宫手术有许多中期和长期临床结果，尤其是针对与二尖瓣疾病相关的房颤。这些改良可能有助于阐明阵发性房颤的机制。基于手术方法的成功以及电生理研究，持续性房颤的机制被推测为多重折返。
日本外科医生对迷宫手术进行了改良和简化，改进了迷宫手术，并有助于阐明房颤的机制。
