[Bilateral Atrial Maze without Left Atrial Incision during Aortic Valve Replacement]

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology
• Arrhythmology

Background:

• Severe aortic stenosis often coexists with atrial fibrillation, complicating surgical management.
• Persistent atrial fibrillation poses risks, including stroke and heart failure, necessitating effective treatment.
• Pulmonary vein isolation alone may be insufficient for certain complex atrial fibrillation cases.

Purpose of the Study:

• To evaluate the efficacy and safety of the Dallas lesion set maze procedure during aortic valve replacement.
• To assess the feasibility of this modified maze technique in patients with persistent atrial fibrillation.
• To determine if this approach provides a viable alternative to standard maze procedures.

Main Methods:

• The Dallas lesion set involves creating specific ablation lines to electrically isolate the left atrium without a full left atriotomy.
• This technique connects epicardial ablation from the left atrium to lines beneath the aortic valve commissures.
• Concomitant aortic valve replacement was performed in all cases.

Main Results:

• Six patients underwent aortic valve replacement with the Dallas lesion set maze procedure.
• All patients achieved sinus rhythm at discharge.
• No bleeding complications or in-hospital mortality were observed.

Conclusions:

• The Dallas lesion set is a safe and effective surgical option for treating atrial fibrillation during aortic valve replacement.
• This technique offers a potentially less invasive alternative for patients with persistent atrial fibrillation refractory to pulmonary vein isolation.
• The Dallas lesion set demonstrates promise as a valuable addition to the surgical armamentarium for complex cardiac conditions.