Evidence map›Paper›PMID 29056264›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2018

Performance of the Cox-maze IV procedure is associated with improved long-term survival in patients with atrial fibrillation undergoing cardiac surgery.

Farah N Musharbash, Matthew R Schill, Laurie A Sinn, Richard B Schuessler, Hersh S Maniar, Marc R Moon, Spencer J Melby, Ralph J Damiano

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  14. How we do it: Biatrial maze.JTCVS structural and endovascular · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Farah N MusharbashDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Matthew R SchillDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Laurie A SinnDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Richard B SchuesslerDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Hersh S ManiarDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Marc R MoonDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Spencer J MelbyDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo.
Ralph J DamianoDivision of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Mo. Electronic address: damianor@wustl.edu.

Funding

SURGICAL TREATMENT OF VENTRICULAR TACHYARRHYTHMIASR01HL032257 · NHLBI · WASHINGTON UNIVERSITY · PI DAMIANO, RALPH J, ZEMLIN, CHRISTIAN W · 1985 to 2025
$10.4M
BASIC SCIENCE RESEARCH TRAINING: CARDIOPULMONARY SURGERYT32HL007776 · NHLBI · WASHINGTON UNIVERSITY · PI DAMIANO, RALPH J · 1994 to 2020
$4.6M
NHLBI NIH HHS R01 HL032257NHLBI NIH HHS T32 HL007776
6 · The paper itself

Abstract

objectiveAtrial fibrillation (AF) is associated with an increased mortality risk. The Cox-maze IV procedure (CM4) performed concomitantly with other cardiac procedures has been shown to be effective for restoring sinus rhythm. However, few data have been published on the late survival of patients undergoing a concomitant CM4.

methodsPatients undergoing cardiac surgery were retrospectively reviewed from 2001 to 2016 (n = 10,859). Patients were stratified into 3 groups: patients with a history of AF receiving a concomitant CM4 (CM4; n = 438), patients with a history of AF unaddressed during surgery (Untreated AF; n = 1510), and patients without AF history (No AF; n = 8911). Propensity score matching was conducted between the CM4 and Untreated AF groups, and between the CM4 and No AF groups.

resultsThirty-day mortality was similar between the matched groups. Kaplan-Meier analysis showed greater survival for CM4 compared to Untreated AF (P = .004). Ten-year survival was 62% for CM4 and 42% for Untreated AF. Adjusted hazard ratio was 0.47 (95% confidence interval, 0.26-0.86, P = .014). No difference in survival was found between CM4 and No AF groups with the Kaplan-Meier analysis (P = .847). Ten-year survival was 63% for CM4 and 55% for No AF. Adjusted hazard ratio was 1.03 (95% confidence interval, 0.51-2.11, P = .929).

conclusionsFor selected patients with a history of AF undergoing cardiac surgery, concomitant CM4 did not add significantly to postoperative morbidity or mortality and was associated with improved late survival compared with patients with untreated AF and a similar survival to patients without a history of AF.

Indexed as

Cardiac Surgical ProceduresHeart DiseasesPostoperative ComplicationsAgedAtrial FibrillationFemaleHumansMaleMiddle AgedOutcome and Process Assessment, Health CareRisk AdjustmentRisk AssessmentSurvival AnalysisTimeatrial fibrillationCox-maze IVsurvival

Identifiers

PMID29056264
PMCPMC5732870

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.