The effects of the Cox maze procedure on atrial function

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The effects of the Cox maze procedure on atrial function Rochus K. Voeller, MD, Andreas Zierer, MD, Shelly C. Lall, MD, Shun–ichiro Sakamoto, MD, Nai–Lun Chang, BS, Richard B. Schuessler, PhD, Marc R. Moon, MD, Ralph J. Damiano, MD The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 5, Pages 1257-1264.e3 (November 2008) DOI: 10.1016/j.jtcvs.2008.01.053 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The modified Cox maze procedure lesion set. All lesions were created off cardiopulmonary bypass with the Atricure Isolator II bipolar radiofrequency ablation device. SVC, Superior vena cava; IVC, inferior vena cava; RF, radiofrequency. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Preoperative versus 30-day postoperative left atrial contribution to left ventricular filling. LABPV, Percentage contribution of left atrial booster pump volume to left ventricular stroke volume; LACV, percentage contribution of left atrial conduit volume to left ventricular stroke volume; LARV, percentage contribution of left atrial reservoir volume to left ventricular stroke volume; LV, left ventricular. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Preoperative versus 30-day postoperative regional left atrial wall motion. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Left atrial (LA) and left ventricular (LV) volume versus cardiac cycle curves. The curve with A, B, C, and D represents a normal left atrial volume curve. Point A, Minimal LA volume; point B, maximal LA volume; point C, relative minimal LA volume; point D, relative maximal LA volume. The curve with E and F represents a normal left ventricular volume curve. Point E, Left ventricular end-diastolic volume; point F, left ventricular end-systolic volume. Left ventricular stroke volume = point E − point F; left atrial reservoir volume = point B − point C; left atrial booster pump volume = point D − point A; Left atrial conduit volume = left ventricular stroke volume − left atrial reservoir volume − left atrial conduit volume. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Regional assessment of left atrial function Regional assessment of left atrial function. The left atrium is divided into 4 segments: anterior, posterior, medial, and lateral. Percentage shortening of each segment during left atrial systole and diastole was measured. The reference point was stationary throughout the cardiac cycle. RA, Right atrium; LA, left atrium; TV, tricuspid valve; MV, mitral valve; RV, right ventricle; LV, left ventricle. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Conductance catheter placement in the right and left atria Conductance catheter placement in the right and left atria. Conductance catheters were inserted into both atria separately to measure pressure–volume relations. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1257-1264.e3DOI: (10.1016/j.jtcvs.2008.01.053) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions