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How To Do It

Totally Extracardiac Maze Procedure Performed on the Beating Heart

^a Division of Cardiothoracic Surgery, Pinehurst Surgical Clinics, Pinehurst, North Carolina
^b Klinikum der Johann Wolfgang Goethe-Universitat, Frankfurt, Germany
^c Brody School of Medicine at East Carolina University, Greenville, North Carolina

Accepted for publication August 14, 2007.

^_* Address correspondence to Dr Kiser, Pinehurst Surgical Clinics, Cardiac and Thoracic Surgery, 5 FirstVillage Dr, Pinehurst, NC 28374 (Email: akiser{at}pinehurstsurgical.com).

The cut-and-sew Cox Maze III procedure is a complex operation. A novel vacuum-integrated radiofrequency ablation device was developed to attenuate the complexity. This device has enabled the development of a totally extracardiac Maze (Ex-Maze) procedure. We describe the Ex-Maze procedure, which closely mimics the gold standard Maze III pattern and includes lines of ablation that isolate the pulmonary veins, interconnect the left and right atria, and a line that extends from the right inferior pulmonary vein to the medial inferior vena cava.