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Ann Thorac Surg 2009;88:1655-1657. doi:10.1016/j.athoracsur.2009.05.046
© 2009 The Society of Thoracic Surgeons
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New Technology

A New Epicardial Lesion Set for Minimal Access Left Atrial Maze: The Dallas Lesion Set

James R. Edgerton, MDa,c,*, Warren M. Jackman, MDb, Michael J. Mack, MDa,c

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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