[HSF] Robotic Cryomaze

Wed Dec 19 16:43:32 EST 2007

Maybe you and Hal type like you drink beer...with your right little pinky sticking out.

tea

----- Original Message ----
From: "wftjrtyler at aol.com" <wftjrtyler at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, December 19, 2007 12:13:19 PM
Subject: Re: [HSF] Robotic Cryomaze

Thanks,Hal??? I do apologize for all the??f @#$%^&*'n ????????????? marks. Must be an?
aol thing.?? bill? 

-----Original Message-----
From: hgrmd at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 19 Dec 2007 8:28 am
Subject: Re: [HSF] Robotic Cryomaze

Bill,

? Your experience with Flex 10 is similar to Crayton Pruitt's.? BTW, I really 
appreciate your unflinching candor in sharing these poor results.? It helps all 
of us in avoiding the same problem.? 

? Like you, I doubt there's much negative info on ganglionic ablation in the 
literature.? However, I know from speaking to experienced surgeons at the 
meetings that the technique doesn't seem to be very effective.? Certainly, 
Damiano and Cox aren't big believers (I've directly posed this question to both 
of them.).? Part of the problem may be that the ganglia somehow regenerate with 
time.

Hal

-----Original Message-----
From: wftjrtyler at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 19 Dec 2007 8:32 am
Subject: Re: [HSF] Robotic Cryomaze

Prasanna, I'm not sure they(papers)?exist.I understand there are some abstracts 
accepted to AATS.this year.?If you or Hal know of any please advise. My small 
series(18cases) with robotic PVI and Flex 10 microwave has( abysmal )success of 
20% at 1 year.?Have done?one procedure with Medtronic platform bilateral small 
thoracotomy VATS. Demonstrated entrance/exit block,transmurality,ganglia 
ablation,blah,blah,blah and still afib at 98 days. Hence my interest in Cox 
cryomaze???? bill turner

-----Original Message-----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 19 Dec 2007 6:51 am
Subject: Re: [HSF] Robotic Cryomaze

Hal, do you have any of those ganglia papers - something that I haven't
really been personally convinced or for that matter really
understood.Likeyou I believe strongly in the mitral isthmic lesion and
more importantly
biatrial lesions and since I do my coronary sinus ablation via the RA my
lesions are always biatrial.

Prasanna

On Dec 19, 2007 8:36 AM, <Hgrmd at aol.com> wrote:

> Dr. Zhou and Prasanna,
>  Eliminating ganglia was something I briefly pursued a couple of   years
> ago.
>  I was never impressed that it increased the success rate.  Certainly,
> Sonny
> Jackman's hypothesis that ganglionic ablation would increase  the success
> rate of PVI sounded attractive, I haven't seen any studies   demonstrating
> a
> convincing advantage.  Dr. Zhou, where did you get this  "15%" improvement
> with
> ganglionic ablation?  Please cite the paper if it is  available.
>  The problem with PVI alone is that it does not effectively cure
>  continuous
> AF.  A mitral isthmus lesion is required to do that.  As  far as I know,
> this
> can only be safely and reproducibly done on pump with  cryo.
>
> Hal
>
>
>
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-- 
Prasanna Simha M
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