[HSF] Power Sources for Cox-Maze

[Tea Acuff]

so you get to sleep in every morning?
tea


----- Original Message ----
From: Ben Bidstrup <benjamin.bidstrup at bigpond.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, April 24, 2007 9:44:54 PM
Subject: Re: [HSF] Power Sources for Cox-Maze


About 3.5 hours earlier than Brisbane

>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       
>>
>>
>>
>>  ************************************** See what's free at 
>>http://www.aol.com.
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon
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