How to spread out the satisfactory exposure: placement technique in right-sided maze procedure
Morishita, A.; Harada, M.; Watanabe, M.
Journal of Cardiovascular Surgery 41(4): 575-577
2000
ISSN/ISBN: 0021-9509 PMID: 11052286 Document Number: 520312
We have, whenever possible, substituted cryoablation for incisions in the maze procedure. Cryoablation helps prevent massive bleeding because the number of resuturing sites is reduced and aortic cross-clamp time decreased. We are careful not to injure the atrio-ventricular conduction system during incision at the side of the Koch triangle or cryoablation while manipulating the atrial septum. In prior versions of the right-sided maze procedure, the IVC return cannula has obstructed the surgical field approaching the IVC and the tricuspid valve annulus. This report describes a new modification of maze procedure that includes changing the venous return site. We have obtained a satisfactory surgical field without being afraid of the anatomical pitfall, between the appendage and the tricuspid valve, and between the right coronary artery and the extended T incision. We studied 12 patients (8 males and 4 females, mean age 61 years) who underwent the maze procedure. Sinus rhythm was restored in 11 patients, whose clinical condition was improved to NYHA class I status. This technique has proven effective in obtaining satisfactory exposure of the-right atrium during the maze procedure.