Clamp Ablation of Pulmonary Veins During Minimally Invasive Aortic Valve Replacement.

Here, we demonstrate bilateral pulmonary vein isolation using a bipolar clamp but without atriotomy during minimally invasive aortic valve replacement. The operation was performed through a right anterolateral minithoracotomy. The right pulmonary veins were ablated by using a radiofrequency clamp on the beating heart. After cardiac arrest, the ascending aorta was pulled up using umbilical tape passed through the transverse sinus. Appendage resection offered fine exposure around the lower pulmonary vein. The bipolar clamp was introduced into the oblique sinus under the aorta, and the left pulmonary veins were ablated. Finally, aortic valve replacement was performed in a standard manner.