Evolution of the maze III procedure: are modifications necessary?

The maze III procedure has been the culmination of multiple surgical approa ches for supraventricular arrhythmias. Its success in curing atrial fibrill ation has generated multiple modifications which constitute attempts to sim plify the operation, particularly with associated mitral or multiple valvul ar pathology. Our preference in these patients, however, has been to employ the original maze ill procedure without modification. This review tracks t he development of the maze III procedure and its modifications and compares the early outcomes in patients requiring the maze procedure combined with mitral and additional valvular procedures.