Aortic Root Replacement With a Konect Prosthesis, Full Cox Maze, and IMA to LAD

This is a video of a sixty-five-year-old man who presented with atrial fibrillation, a critical LAD lesion, and heart failure with severe aortic regurgitation and a root dilated to 48 mm.

To begin, the SVC was cannulated and a percutaneous IVC cannula was placed from the femoral vein. The IVC was then clamped off in the pericardium after aortic cannulation. The right atrium was opened on the patient’s beating heart, but retrograde could not be easily given so the aorta was opened and direct cardioplegia was given. 

The Cox maze procedure was commenced by performing the tricuspid annulus lesions with a Bovie diathermy. Then, the left atrium was opened and a combination of cut and sew lesions and cryoablation lesions were used to isolate the pulmonary veins and perform an endocardial and epicardial mitral isthmus lesion. The left atrium was then closed and an explosion diagram of the root was created by taking left and right buttons and excising the aortic valve. A Konect root replacement was then placed, and the operation was completed.

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