Transaortic Delivery of the Transmitral Lesion in a Complete Maze Procedure

A 68-year-old hypertensive diabetic woman with chronic atrial fibrillation presented with progressive congestive symptomatology. She was diagnosed with severe aortic stenosis, moderate mitral regurgitation, and critical right coronary artery stenosis. In addition to coronary revascularization and bioprosthetic aortic valve replacement, she underwent a mitral valve repair and a complete cryoMaze procedure through a transaortic approach. This technique obviates a separate left atriotomy for the mitral repair and Maze procedure. It affords excellent exposure, while reducing cross clamp and cardiopulmonary bypass time as well as avoiding the potential sequelae of bleeding and traction injuries resulting from a left atriotomy.