How to spread out the satisfactory exposure: Placement technique in right-sided maze procedure

We have, whenever possible, substituted cryoablation for incisions in the m aze procedure. Cryoablation helps prevent massive bleeding because the numb er of resuturing sites is reduced and aortic cross-clamp time decreased,We are careful not to injure the atrio-ventricular conduction system during in cision at the side of the Koch triangle or cryoablation while manipulating the atrial septum. In prior versions of the right-sided maze procedure, the IVC return cannula has obstructed the surgical field approaching the NC an d the tricuspid valve annulus. This report describes a new modification of maze procedure that includes changing the venous return site. We have obtai ned a satisfactory surgical field without being afraid of the anatomical pi tfall, bem-een the appendage and the tricuspid valve, and between the right coronary artery and the extended T incision. We studied 12 patients (8 mal es and 4 females, mean age 61 years) who underwent the maze procedure. Sinu s rhythm was restored in 11 patients, whose clinical condition was improved to NYHA class I status. This technique has proven effective in obtaining s atisfactory exposure of the-right atrium during the maze procedure.