[HSF] AF - LCPV

[Nasser F. Abou'Seada]

Very interesting Prasanna ..... your photos are very illustrating .... that
is a great point of consideration. I am using spray cauterization for the
mouths of the pulmonary veins.... I know of some colleagues doing that as
well .... but for sure your experience is far ahead of ours .....
I have some queries ...
- how can you be sure that the lesion is "enough" ?
- what is your "end point" in applying the spray cauterization ?
-  .... how do you recognize it ... the "end point" I mean ?
 - what about the trans-murality issue ?
- Do you do the same thing for the Right Common Pulmonary Vein?

NFA


On 6/4/07, prasannasimha <prasannasimha at gmail.com> wrote:
>
> Same wattage (40 Spray) but the mouth of the pulmonary veins should not
> be mistaken for just the burn - more importantly the common ostial
> origin needs to be burnt.
> The picture labeled dual orifice represents two separate orifices.
> The picture labeled common pulmonary vein orifice shows a common
> pulmonary vein orifice stretched open (There are actually two orifices
> within it and the sucker has gone into one)whereas it looks like common
> pulmonaryvein2 when unstretched.Burning within this just the individual
> ostia would leave a left atrial trigger within the common pulmonary vein
> area.
> Prasanna
> Nasser F. Abou'Seada wrote:
> > Dear Prasanna, would you please elaborate more on how you do tackle this
> > point of ablating the left common pulmonary vein - the common
> > orifice- utilizing your technique of spray diathermy? .... what
> > energy settings do you use here at this site, compared to other sites ?
> >
> > NFA
> >
> > On 6/3/07, prasannasimha <prasannasimha at gmail.com> wrote:
> >>
> >> The left superior pulmonary vein is one of the most common sites of
> Afib
> >> triggers and this is the one which is most important to ablate.
> >> Unfortunately many do not pay attention to it and then complain of
> >> reduced rates of conversion of Afib.The other variation to pay special
> >> attention is the left common pulmonary vein- the common orifice should
> >> be ablated as there are triggers between the common ostium and the
> >> individual ostia and is another important consideration.
> >>
> >> Prasanna
> >> Hgrmd at aol.com wrote:
> >> > John,
> >> >   I've used Cryocath for the last 4-5 years.  I've got a poster  in
> >> the
> >> > upcoming Society of Heart Valve Disease in 10 days in which my
> >> results
> >> were
> >> > outlined. You can go to their website and get the  abstract.  The
> >> bottom
> >> line is
> >> > that 95% of the patients were in AV synchrony  at their last
> >> followup.  That is
> >> > quite comparable to a "cut and sew"  maze.  One of the main
> advantages
> >> it has
> >> > over Atricure is that the left  pulmonary vein lesions are done
> >> endocardially.
> >> > Dissecting the left  pulmonary veins on a redo so that you can get an
> >> > Atricure clamp around them is  no picnic.
> >> > Hal
> >> >
> >> >
> >> >
> >> > ************************************** See what's free at
> >> http://www.aol.com.
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC