Box Lesion with Single Radiofrequency Clamp

We introduce a maneuver to perform the box lesion as a part of Cox maze IV procedure with single radiofrequency clamp. The maneuver entails engaging the right pulmonary veins with the clamp, then advancing the clamp jaws underneath the superior vena cava through the transverse sinus to include the roof and the left pulmonary veins in the clamp. We regularly use this technique for box lesion with desirable transmurality.