Abstract
Background. The MAZE-III is the surgical treatment of choice for medically refractory atrial fibrillation. Although a number of nonsurgical techniques are evolving to duplicate the transmural atrial lesions of the MAZE-III, the surgical atriotomy remains the gold standard for conduction block. It was the objective of this study to surgically create the atrial incisions of the MAZE-III without the use of cardiopulmonary bypass. Methods. A technique was developed to create and intersect the linear incisions of the MAZE-III on 10 beating canine hearts without the use of cardiopulmonary bypass using a 'tunnel' of atrial tissue. The effectiveness of the procedure was tested by atrial burst pacing. Results. This technique was successfully performed on 10 mongrel dogs without operative mortality. Preoperatively, sustained atrial fibrillation (> 30 seconds) was induced in all animals. Postoperatively, all the animals remained in sinus rhythm even after burst pacing. Conclusions. In an experimental canine model, the MAZE-III can be performed on beating hearts without the assistance of cardiopulmonary bypass using a 'tunnel' technique. This technique allows for the immediate assessment of electrophysiologic and mechanical function after the MAZE-III, or any other type of procedure using the 'maze principle' and may find future application in the clinical arena.
Original language | English (US) |
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Pages (from-to) | 1696-1702 |
Number of pages | 7 |
Journal | Annals of Thoracic Surgery |
Volume | 67 |
Issue number | 6 |
DOIs | |
State | Published - Jun 1999 |
Funding
This work was supported by the National Institutes of Health grants 5 R01 HL32257 and 5 T32 HL07776.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery