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 Scopus citations

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
Publication statusPublished - Jun 1 1999
Externally publishedYes

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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