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

Abstract

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. 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. Using these minimal access procedures, we have obtained a complete block across all lesion lines in all patients. These techniques have made it possible to perform the full Cox maze III left atrial lesion set with minimal access techniques.