[HSF] Indications for maze with mitral surgery

[Dwight Hand]

There are a lot of lesion sets out there and a lot of energy sources and a lot of claims about efficacy with variable end points and follow-up methods - some  are word of mouth only and have not been published or have stood up to review.  Damiano has advanced the Cox Maze III lesion set characterized by open "cut & sew" + cryo technology to a new era paradigm of Bipolar radiofrequency clamp +/- purse-string with cryoablations termed "Maze IV."  Others have advocated abreviated lesion sets with alternative energy sources, abreviated follow-up times, and less than optimal results.  In order to convince all interested parties (patients, referral sources, third party payors) that AF ablation by whatever means (surgical or interventional) is the way to go, we as surgeons will need to demonstrate procedural efficacy, cost effectiveness, minimal complications, and a minimally invasive approach to displace medical treatment alone.
Dwight

> Date: Sun, 2 Mar 2008 00:06:15 +0530
> From: prasannasimha at gmail.com
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Indications for maze with mitral surgery
> CC: 
> 
> I had done a study which I presented in the Asian meet held at Mumbai
> in which (for chronic Afib) I did emazes in 3 sets - biatrial, left
> +epicardial right and left only. To get a 90 + conversion rate you
> need to do a biatrial set of lesions. Lesser mazes give a 60 + approx
> conversion rate.
> Prasanna
> 
> On Sat, Mar 1, 2008 at 11:02 PM,  <hgrmd at aol.com> wrote:
> > Mitch,
> >   For the open cases I do a full set on the left and a flutter line on the right.
> >
> >
> >  Hal
> >  Sent from my Verizon Wireless BlackBerry
> >
> >  -----Original Message-----
> >
> >
> > From: Mitch Lirtzman <drmitch at cox.net>
> >
> >  Date: Sat, 01 Mar 2008 09:44:07
> >  To:OpenHeart-L at lists.hsforum.com
> >  Subject: Re: [HSF] Indications for maze with mitral surgery
> >
> >
> >  Hal,
> >  When you indicate a " full Cox-maze", do you mean right and left-sided
> >  lesions, or just the left atrial set? Thanks.
> >  MitchAt 07:43 AM 2/29/2008, you wrote:
> >  >ps you can also wave the cautery around for no extra cost !!
> >  >Prasanna
> >  >
> >  >On Fri, Feb 29, 2008 at 6:45 PM, Dr. Roberto Battellini
> >  ><battr at medizin.uni-leipzig.de> wrote:
> >  > > Don,
> >  > >  In Leipzig yes, we have the atria open and we have the Cryocath, and takes
> >  > >  15 minutes.
> >  > >  Roberto
> >  > >
> >  > >  -----Ursprüngliche Nachricht-----
> >  > >  Von: openheart-l-bounces at lists.hsforum.com
> >  > >  [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Donald Ross
> >  > >  Gesendet: Freitag, 29. Februar 2008 05:05
> >  > >  An: OpenHeart-L at lists.hsforum.com
> >  > >  Betreff: Re: [HSF] Indications for maze with mitral surgery
> >  > >
> >  > >
> >  > >
> >  > >  Dear Colleagues,
> >  > >  Does a history of paroxysmal AF constitute an indication for
> >  > >  concomitant maze in mitral surgery?
> >  > >  Don
> >  > >_______________________________________________
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> >  >--
> >  >Prasanna Simha M
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> 
> -- 
> Prasanna Simha M
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