The closed heart MAZE: A nonbypass surgical technique

Richard Lee, Takashi Nitta, Richard B. Schuessler, David C. Johnson, John P. Boineau, James L. Cox

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background. The MAZE-III is the surgical treatment of choice for medically refractory atrial fibrillation. Although a number of nonsurgical techniques are evolving to duplicate the transmural atrial lesions of the MAZE-III, the surgical atriotomy remains the gold standard for conduction block. It was the objective of this study to surgically create the atrial incisions of the MAZE-III without the use of cardiopulmonary bypass. Methods. A technique was developed to create and intersect the linear incisions of the MAZE-III on 10 beating canine hearts without the use of cardiopulmonary bypass using a 'tunnel' of atrial tissue. The effectiveness of the procedure was tested by atrial burst pacing. Results. This technique was successfully performed on 10 mongrel dogs without operative mortality. Preoperatively, sustained atrial fibrillation (> 30 seconds) was induced in all animals. Postoperatively, all the animals remained in sinus rhythm even after burst pacing. Conclusions. In an experimental canine model, the MAZE-III can be performed on beating hearts without the assistance of cardiopulmonary bypass using a 'tunnel' technique. This technique allows for the immediate assessment of electrophysiologic and mechanical function after the MAZE-III, or any other type of procedure using the 'maze principle' and may find future application in the clinical arena.

Original languageEnglish (US)
Pages (from-to)1696-1702
Number of pages7
JournalAnnals of Thoracic Surgery
Volume67
Issue number6
DOIs
StatePublished - Jun 1 1999

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Cardiopulmonary Bypass
Atrial Fibrillation
Canidae
Theoretical Models
Dogs
Mortality

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, R., Nitta, T., Schuessler, R. B., Johnson, D. C., Boineau, J. P., & Cox, J. L. (1999). The closed heart MAZE: A nonbypass surgical technique. Annals of Thoracic Surgery, 67(6), 1696-1702. https://doi.org/10.1016/S0003-4975(99)00268-4

The closed heart MAZE : A nonbypass surgical technique. / Lee, Richard; Nitta, Takashi; Schuessler, Richard B.; Johnson, David C.; Boineau, John P.; Cox, James L.

In: Annals of Thoracic Surgery, Vol. 67, No. 6, 01.06.1999, p. 1696-1702.

Research output: Contribution to journalArticle

Lee, R, Nitta, T, Schuessler, RB, Johnson, DC, Boineau, JP & Cox, JL 1999, 'The closed heart MAZE: A nonbypass surgical technique', Annals of Thoracic Surgery, vol. 67, no. 6, pp. 1696-1702. https://doi.org/10.1016/S0003-4975(99)00268-4
Lee R, Nitta T, Schuessler RB, Johnson DC, Boineau JP, Cox JL. The closed heart MAZE: A nonbypass surgical technique. Annals of Thoracic Surgery. 1999 Jun 1;67(6):1696-1702. https://doi.org/10.1016/S0003-4975(99)00268-4
Lee, Richard ; Nitta, Takashi ; Schuessler, Richard B. ; Johnson, David C. ; Boineau, John P. ; Cox, James L. / The closed heart MAZE : A nonbypass surgical technique. In: Annals of Thoracic Surgery. 1999 ; Vol. 67, No. 6. pp. 1696-1702.
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