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Updated: Jul 15, 2026
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Transaortic delivery of the transmitral lesion in a complete maze procedure
Lucian Lozonschi1, John H Sirak, Robert E Michler
1Department of Cardiothoracic Surgery, Ohio State University Medical Center, Columbus, Ohio, USA.
Insights
This study presents a novel transaortic approach for aortic stenosis repair, incorporating mitral valve repair and the cryoMaze procedure. This technique simplifies the surgical process and reduces patient risk.
Area of Science:
- Cardiac Surgery
- Minimally Invasive Techniques
- Electrophysiology
Background:
- A 68-year-old woman with hypertension, diabetes, and chronic atrial fibrillation presented with congestive symptoms.
- Diagnosis revealed severe aortic stenosis, moderate mitral regurgitation, and critical coronary artery stenosis.
Observation:
- The patient underwent coronary revascularization and bioprosthetic aortic valve replacement.
- A mitral valve repair and a complete cryoMaze procedure were performed simultaneously via a transaortic approach.
Findings:
- The transaortic approach eliminated the need for a separate left atriotomy for mitral repair and the Maze procedure.
- This technique provided excellent surgical exposure.
- It successfully reduced aortic cross-clamp and cardiopulmonary bypass times.
Implications:
- The transaortic approach minimizes bleeding and traction injuries associated with left atriotomy.
- This method offers a potentially safer and more efficient surgical option for complex cardiac procedures.
- Further research can explore the long-term benefits and broader applicability of this technique in treating valvular heart disease and atrial fibrillation.
Abstract:
A 68-year-old hypertensive diabetic woman with chronic atrial fibrillation presented with progressive congestive symptomatology. She was diagnosed with severe aortic stenosis, moderate mitral regurgitation, and critical right coronary artery stenosis. In addition to coronary revascularization and bioprosthetic aortic valve replacement, she underwent a mitral valve repair and a complete cryoMaze procedure through a transaortic approach. This technique obviates a separate left atriotomy for the mitral repair and Maze procedure. It affords excellent exposure, while reducing cross clamp and cardiopulmonary bypass time as well as avoiding the potential sequelae of bleeding and traction injuries resulting from a left atriotomy.
