[HSF] Indications for maze with mitral surgery

Mitch Lirtzman drmitch at cox.net
Sat Mar 8 10:46:41 EST 2008


Prasanna, it seems my messages are as blank as my goofy computer. Got fried 
in a thunderstorm the other nite. The diagram I asked for came over the HSF 
just after I posted to you the other day. Thanks for you foresight in 
anticipating my need for a visual aid.
Mitch
At 11:39 AM 3/7/2008, you wrote:
>Mitch , all your emails are coming as a blank !!
>Prasanna
>
>On Fri, Mar 7, 2008 at 8:58 AM, Mitch Lirtzman <drmitch at cox.net> wrote:
> >
> > Drawing a diagram, of course!At 07:35 PM 3/2/2008, you wrote:
> >  >On Mon, Mar 3, 2008 at 7:00 AM, Mitch Lirtzman <drmitch at cox.net> wrote:
> >  > > Prasanna, you are such a good artist, (physician/ surgeon/ 
> computer jock),
> >  > > would you mind?
> >  >Would I mind doing what ? The message has got truncated.
> >  >Prasanna
> >  >At 03:17 AM 3/2/2008, you wrote:
> >  > >  >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
> >  > >  > >  > >
> >  > >  > >  > >
> >  > >  > >  > >
> >  > >  > >  > >  **************Ideas to please picky eaters. Watch video 
> on AOL
> >  > >  > Living.
> >  > >  > >  > >  (
> >  > >  > >  >
> >  > >  >
> >  > 
> http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/
> >  > >  > >  > >  2050827?NCID=aolcmp00300000002598)
> >  > >  > >  > >
> >  > >  > >  > >
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