Posted by Carl Plaskett on August 04, 2002 at 09:49:25:
In Reply to: Open heart OR? posted by Rob on August 04, 2002 at 02:40:09:
Rob: The open chest routine is definitely NOT outdated, and is preferred by several surgeons for a number of reasons, which include: Less pain for the patient, since there are few nerves and no muscle tissue in the area of the sternum, compared to one of the mini-procedures which goes through the ribs and necessitates deflating the right lung so the instruments can reach one's heart.
If you have some other need for "open heart" surgery (valve, bypass, etc.) then it is a "no brainer", get the maze done while they're in there!
You can judge for yourself, but it SEEMS to me that more people who undergoe a "mini" procedure report subsequent arrhythmias post-maze, BUT just about all of them ultimately reach NSR (although some require "touch-up" ablations).
I asked Dr. Cox about this paradox when I met him socially in June, and he completely agreed with my "layman's" conclusion about which method had the fewest post operative arrhythmias and pain.I would weigh how much afib and the drugs intefer with your life and health against waiting for the "next best thing to come down the pike". It might be longer than you want to wait in Australia.
If your surgeon has a good success record (ask him for referrals. How many has he done? How does he create the maze "lines"? Cut & sew? C&S with cryo ablation (The Cox Maze III "gold standard")?
The newest nearly "non-invasive" Cox Maze is still in developmental stages, but as Dr. Cox said in his email which I copied and posted a few weeks ago, it is about to go for approval for trials on human patients. This technique is certainly at least a couple of years away from being used in more than a very few centers, if the trials are successful.
As far as ablations go, the US is probably waaay ahead, particularily at the CC, where the success stories keep multiplying weekly, with their use of the newest "tools".