Maze手術の変法とradial手術の変遷―洞調律回復と生理的心房興奮の維持をめざして

Modification of Maze Procedure in Nippon Medical School：Striving Towards Restoration of Sinus Rhythm with Physiological Activation of Atria

心房細動手術，いわゆるmaze手術はワシントン大学心臓血管外科のCox医師および電気生理学者のBoineau博士により考案され，1987年に臨床で開始された．このCox-maze手術は術式の変遷を経て1995年にCox-maze Ⅲ手術が報告されている1）．本学では1991年に同手術法の変法を，1993年に原法どおりのCox-maze手術を開始した．

Atrial fibrillation surgery is beneficial for restoring sinus rhythm and maintaining the physiological atrial contraction to prevent left atrial thrombus formation. The radial procedure, a good alternative to the maze procedure, has been performed at Nippon Medical School；it was designed to maintain physiological atrial excitation and blood flow. The design reduces the incision line and avoids conduction delay in the atrium through the use of ablation devices and intraoperative mapping of atrial excitation patterns. In addition, it preserves sinus node function and cardiac conduction pathway；this could prevent postoperative pacemaker implantation.