Posted by Carl Plaskett on January 05, 2004 at 12:43:50:
In Reply to: Re: Back in Afib posted by Glenn Camp on January 05, 2004 at 11:47:05:
Glenn: Tim Hawkins is a more recent (2002) Mazer from the CC who had his FAA certificate (commercial airline) reinstated. Tim kept detailed recordings of his HR during steep walks/jogs/runs post-maze. As I recall he had lots of PACs, blips, rapid rate in the first few months, then they abruptly stopped. He still had to wait until 6 months to apply for reinstatement, which was granted after a physical. His story a few months ago about having the nose of his airliner struck by lightning and staying in NSR through the whole experience was "heartwarming" to all of us, when he wrote that now he KNOWS he is cured!
Regarding your question to John, I believe that most maze procedures are being done with less and less of the "cut & sew" technique developed by Dr. Cox (listen to the audio "link" of Dr. Daminano of Washington Univ. @ St. Louis, which Judy posted over the weekend) and more and more alternative energy sources for the Maze lines/lesions. In my case, 3 years ago at the CC, I had a combination of "cut & sew" and cryoablation, with a total "pump time" of about 45 minutes. They may have reduced the pump time by now for patients similar to me, by using RF,Microwave, or Ultrasound instruments. It seems, from reading info the CC has had on their website, that some of these alternative energy sources do not create lesions to the depth of cut & sew or cryo, and electrical pathways sometimes re-emerge, hence "touch-up" ablations. Some patients also have thicker heart muscle which contributes to this problem.
There may still be surgeons who know that the "gold standard" Maze III, with mostly cut & sew/cryo has the best long-term results, and are still following that protocol. Ask whomever you are considering as to what their success rate is for THE procedural combination they would use for YOU, and not just their success rate overall. Ask why they are doing things differently (if, in fact they are)now than before.
Most of the "modified" Maze procedures have been developed to try to make the procedure seem less "threatening" to the patient by reducing pump time, lessen the risks of bleeding, stenosis, etc. SOME of them may be the result of a facility not being equipped with some of the available equipment so they have had to "make do" with what they have. Still others MAY be the result of not enough training, which is what makes us successful patients high on the facilities/doctors with LOTS of experience and equipment. Our successes, even more recent ones, speak volumes!