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a The Heart Hospital, Plano, Texas
b Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
c Medical City Dallas Hospital, Dallas, Texas
Accepted for publication May 6, 2009.
* Address correspondence to Dr Edgerton, 4708 Alliance Blvd, Ste 700, Pavilion 1, Plano, TX 75093 (Email: edgertonjr{at}aol.com).
Purpose: Improvements in enabling technology have facilitated minimal access techniques to the surgical ablation of atrial fibrillation. A variety of lesion sets (usually targeting only the left atrium) have been used in attempts to ablate atrial fibrillation. We describe a new epicardial approach to apply a set of left atrial lesions, which are electrophysiologically equivalent to all the left atrial lesions of the Cox maze III while using minimal access techniques.
Description: Using minimal access techniques, we have isolated the pulmonary veins and made connecting lesions on the dome of the left atrium to create a set of lesions electrophysiologically equivalent to all the left atrial lesions of the Cox maze III. Intraoperative electrophysiological evaluation is used to insure complete isolation across each lesion line.
Evaluation: Using these minimal access procedures, we have obtained a complete block across all lesion lines in all patients.
Conclusions: These techniques have made it possible to perform the full Cox maze III left atrial lesion set with minimal access techniques.
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