title: How to spread out the satisfactory exposure: placement technique in right-sided maze procedure.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Gunma Heart Institute, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Morishita
authors.forename: M
authors.initials: M
authors.lastname: Harada
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D003452:Cryosurgery; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged