[HSF] Indications for maze with mitral surgery

[Prasanna Simha M]

The right atrial lesions are
One from the SVC to IVC.
Two from the previous lesion crossing the crista to the atrial incision.
Three from the IVC  via the tricuspid isthmus to the tricuspid valve.
Four Burn the mouth of the coronary sinus with the burn going in the
mouth at the triangle of Koch
Five Join the SVC_IVC lesion to the CS and then to the TV isthmic burn
Six - from SVC to above the anteroseptal commissure of the tricuspid valve
Seventh -  is to go from the RA incision over the RA appendage on to
the dome of the LA keeping a 3mm gap over the SA nodal artery. I have
omitted this when I have taken lesion 6 at times in redos with no
difference in conversion rates so I think lesion 7 may be omitted.

Prasanna

On Sun, Mar 2, 2008 at 1:33 PM, nand kejriwal <nkkejriwal at gmail.com> wrote:
> Prasanna
>
>  What lesions do you create in the right atrium? Do you do just the CS mouth
>  lesion or the full set including the one from SVC to IVC and another towards
>  the TV, in all your cases.
>
>  Nand
>
>
>
>  On 3/2/08, Prasanna Simha M <prasannasimha at gmail.com> wrote:
>  >
>  > I ablate the mitral Isthmus and I burn the coronary sinus mouth from
>  > the RA as a part of the biatrial set and believe that both are very
>  > important. When I did the comparative study the "epicardial right +
>  > endocardial left" was designed with elimination of the CS mouth lesion
>  > and the superior RA to TV lesion being omitted.The isthmic burn was
>  > attemopted in that set by burning externally from IVC to TV. The left
>  > atrial set included the mitral isthmic lesion.
>  > Lesser mazes did give a lower conversion rate.
>  >
>  > One of my friends from PGI Chandigarh gave eMAZE as the topic for the
>  > thesis of his postgraduate student and his findings also confirmed
>  > that an abbreviated set of lesions has a lower conversion rate.
>  >
>  >
>  > On Sun, Mar 2, 2008 at 3:56 AM,  <Hgrmd at aol.com> wrote:
>  > > Prasanna,
>  > >   Do you ablate the mitral isthmus and the coronary sinus with
>  > the  cautery?
>  > >
>  > >  Hal
>  > >
>  > >
>  > >
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>  > >
>  > >
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>  > Prasanna Simha M
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-- 
Prasanna Simha M