This video demonstrates a Cox-Maze III operation combined with a left internal mammary artery (LIMA) to left anterior descending artery (LAD), as well as an ascending aortic replacement and aortic valve resuspension.
The Cox-Maze III was performed after superior vena cava (SVC) cannulation and inferior vena cava (IVC) cannulation percutaneously. Antegrade cardioplegia was administered. The ascending aorta was removed, and the aortic valve was resuspended.
A Chitwood clamp was placed on the IVC to avoid having to go around it. The right atrium was opened.
A full-thickness burn was made by the coronary sinus, and then it was sutured closed. A second burn was made around the right atrial appendage. Next, a left atrial incision was made in Sondergaard’s groove, and this was continued up to the pulmonary veins on the left, both above and below. Approximately 2 cms above the left pulmonary veins was preserved and frozen, which facilitated easier closure.
The left atrial appendage was excised and stapled.
The left atrium was then closed after a coronary sinus freeze and a right atrial freeze. Finally, the aorta was replaced, and the operation was completed.
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