Beating-heart ablation of the cavo-tricuspid isthmus.
Atrial flutter onset following 'mini-Maze' procedures worsens patient recovery and prolongs hospital-stay. It has been demonstrated that atrial flutter recurrence following isolated left-sided 'mini-Maze' often originates from the right cavo-tricuspid isthmus. We report here a simple procedure to ablate the cavo-tricuspid isthmus, either on cardio-pulmonary bypass and/or off-pump. Two ablation lines were made with an irrigated bipolar radiofrequency clamp, starting from a purse-string suture in front of the coronary sinus toward the coronary sinus and the atrio-ventricular groove, respectively. Another ablation line is directed toward the right appendage. A purse-string suture on the right appendage is used to connect the inferior with the superior vena cava, thus ablating the terminal crest.
Cardiac Surgery Unit, Magna Graecia University, Catanzaro, Italy.
Antonio
A
di Virgilio
Francesco
F
Onorati
Pasquale
P
Mastroroberto
Attilio
A
Renzulli