Totally extracardiac Maze procedure performed on the beating heart

Area of Science:

• Cardiac Surgery
• Minimally Invasive Procedures
• Electrophysiology

Background:

• The Cox Maze III procedure is the gold standard for treating atrial fibrillation but is technically demanding.
• Complexity of the traditional Maze procedure limits its widespread adoption.
• Advancements in ablation technology are sought to simplify surgical approaches.

Purpose of the Study:

• To introduce a novel vacuum-integrated radiofrequency ablation device.
• To describe the totally extracardiac Maze (Ex-Maze) procedure developed using this device.
• To demonstrate how the Ex-Maze procedure mimics the Cox Maze III pattern.

Main Methods:

• Development of a vacuum-integrated radiofrequency ablation device.
• Performance of the totally extracardiac Maze (Ex-Maze) procedure.
• Application of ablation lines to isolate pulmonary veins, interconnect atria, and connect pulmonary veins to the inferior vena cava.

Main Results:

• The novel device facilitates a less complex surgical approach.
• The Ex-Maze procedure effectively replicates the ablation pattern of the Maze III procedure.
• Specific ablation lines were successfully created to achieve the desired atrial isolation and interconnection.

Conclusions:

• The totally extracardiac Maze (Ex-Maze) procedure, utilizing a novel vacuum-integrated radiofrequency ablation device, offers a simplified alternative to the Cox Maze III procedure.
• This technique maintains the efficacy of the gold standard Maze III pattern.
• Further evaluation of the Ex-Maze procedure's clinical outcomes is warranted.