[HSF] Power Sources for Cox-Maze

[Tea Acuff]

Just for the record, what would 12 O clock be in India? 
tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, April 22, 2007 10:54:09 AM
Subject: Re: [HSF] Power Sources for Cox-Maze


The lesions are definitely put there.  The way the lesions are put are 
such that collateral damage are avoided .
The Mitral lesion is put around 5 or 4 O clock and avoids any major circ 
lesion.
The tricuspid Isthmus lesion is actually what the cardiologists regular 
burn with RF catheters and the anterior burn is taken over the  
anterospetal commissure and thus avoids the AV node there.
The CS lesion is placed at the coronary sinus mouth and goes within the 
mouth for safety in the area subtended by the triangle of Koch. A common 
mistake is to assume the CS mouth abuts the AV node and bundle of His - 
this is at the apex of the triangle of Koch and not at the CS mouth.This 
is amply demonstrated in a VSD closure.
Having burnt over 500 of these I can tell you that CHB doesn't occur !!
Years back I did a study with "lesser maze " configurations versus a 
full e maze and presented it in the Asian society of CV surgeons and the 
summary is what you say - lesser lesions give a lower conversion.
The lesions are placed with a spray mode specifically . Both the setting 
and Wattage are critical.
Prasanna

Hgrmd at aol.com wrote:
> Bojan, I'm not exactly sure how Prasanna does an e-maze.  If he  doesn't use 
> any cryo for the mitral isthmus, tricuspid isthmus, and the coronary  sinus, 
> he either has to Bovie these areas or leave them alone.  If he does  Bovie 
> these areas, I would be concerned about collateral damage the coronary  sinus, 
> circumflex, or the mitral and tricuspid valves.  If he doesn't  address these 
> sensitive areas, then I guarantee you that the success rate has to  be 
> compromised.  When I used Atricure (bipolar RF), I still used a  cryoprobe 
> (Frigitronics, Cooper Medical) to create the above lesions.   After nearly 7 years and 
> several hundred mazes later, I've yet to see any  collateral damage while still 
> creating a full set of lesions.
> Hal        
>
>
>
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