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Clamp Ablation of Pulmonary Veins During Minimally Invasive Aortic Valve Replacement  Toshinori Totsugawa, MD, PhD, Arudo Hiraoka, MD, Kentaro Tamura,

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1 Clamp Ablation of Pulmonary Veins During Minimally Invasive Aortic Valve Replacement 
Toshinori Totsugawa, MD, PhD, Arudo Hiraoka, MD, Kentaro Tamura, MD, PhD, Hidenori Yoshitaka, MD, PhD, Taichi Sakaguchi, MD, PhD  The Annals of Thoracic Surgery  Volume 104, Issue 6, Pages e471-e473 (December 2017) DOI: /j.athoracsur Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (a) The ascending aorta (Ao) was pulled up (arrow) by using umbilical tape (UT) passed through the transverse sinus. The exposed left atrial appendage (LAA) was resected with a surgical stapling device. (b) The ligament of Marshall (LM) was divided, revealing the left upper pulmonary vein (LPV). (c) Traction of the aortic root using a narrow spatula (S, arrow) is useful for exposing the left lower pulmonary vein (LPV). A large Satinsky clamp was introduced into the oblique sinus from the left atrial roof. (d) A radiofrequency clamp (RC) was set onto the left atrium (arrow) using Glidepath tape (GT) (AtriCure, Inc, Cincinnati, OH) as a guide. The Annals of Thoracic Surgery  , e471-e473DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Intraoperative photograph of left pulmonary vein isolation using a bipolar clamp through a right minithoracotomy. The Annals of Thoracic Surgery  , e471-e473DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions


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