Posted by John Behle on January 05, 2004 at 13:01:35:
In Reply to: Re: The silent majority posted by Glenn Camp on January 05, 2004 at 11:36:50:
My MAZE was a full open chest using cryoablation for all but I believe one area. There is one problematic area that seems to be the cause of the need for most "touch up" ablations. My surgeon used a cut and sew on that area while the rest was cryoablation.
At first I wondered why the open chest. Later, as I read accounts here, it appears that there are more complications (especially with that one area mentioned before) with the "mimimally invasive" techniques. I'm sure that will cause an argument, but just in reading the accounts here, it stands out.
I also was puzzled why my surgeon would use full open chest when he and the surgeons he practices with are pioneers in minimally invasive surgery techniques. Now, it could be somewhat standard in that most of his MAZE operations include valve repair or other open heart related procedures. My operation was solely a MAZE though he had concern that he might need to put a band around my Mitral Valve to tighten it up, though he didn't need to.
From a safety standpoint, the full open chest procedure requires less time on the bypass and gives the surgeon more access. As I have read, this problematic area that they refer to as the "Achilles Heel" of the MAZE can be hard to get to through minimally invasive techniques. In one case mentioned here, a nerve was nicked during a minimally invasive technique causing severe complications. In addition, if there were some kind of problem, the full access would be beneficial.
Because of the lack of easy access to parts of the heart, some of the minimally invasive procedures concentrate on one side of the heart with the plan of going back in for an ablation if it does not fully do the job. Some surgeons are trying different lines and techniques in different areas of the world and at different hospitals. The MAZE may be a thing of the past soon or look radically different than it does now, but I refuse to be a guinea pig or make a decision on a less desirable surgeon, location or technique because of cost or my location.
Personally I think the rush and fervor to find a simple outpatient procedure leads to experimentation and less successful outcomes. I would not have a PVI, nor would I have another ablation or hit and miss technique. I even looked into a very high tech mapping procedure before my MAZE, but the success ratio of the MAZE and it's proven history had me convinced - and still does.
After so many years of Afib and all it's problems, I was a bit of a pessimist. I figured I would be on the low end of the statistics - and if it could happen, it would happen to me. Even with the low chance of death or complications, I had hit a point where I would rather of died on the table than to go on any longer with the minimal excuse of a life that I had at the time.
Maybe soon a comparable procedure to the MAZE will be here. I personally don't beleive that time is now. Shortly a better procedure may be available, but possibly not yet. If I still had AFIB - I would rush to the MAZE today. So what, I have a scar on my chest. That's it. It was helpful during recovery. I could point to it with my three year old and say "OWWIEE!" and he would get the point not to jump on me.
But, a zipper down my chest is the only memory I have of AFIB or the surgery.
- Re: The silent majority Glenn Camp 15:37:40 1/05/2004 (0)