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Robotic Maze Surgery Vs. Ablation
Posted by cornerbax
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Robotic Maze Surgery Vs. Ablation October 17, 2023 05:21PM |
Registered: 10 months ago Posts: 183 |
After about a year it appears that my Afib has actually been caused by Mitral Valve Regugitation. I have
Mitral Prolapse (Of the Posterior Leaflet). Many doctors totally disregarded my Echo's which showed this
moderate to Severe mitral regurgitation. Those cardiologists/EP's only stated to get an ablation. Fast forward
to now, my current Cardiologist and EP state they believe my AFIB is solely caused from the Severe Mitral
Regurgitation. My Ejection Fraction is 52%. All Chambers of my heart are excellent, except the Left Atria which
is severely enlarged. I was told the left atria is enlarged because of both the AFIB and the Mitral Regurgitation.
At any rate, it looks like i'm going to have the Minimally Invasive Robotic Mitral Valve Surgery. My Doctor said
at the same time, a Maze Procedure can be done to correct the AFIB. I have heard and read a little on Maze
Procedure before but can't find much info on whether a Maze procedure would be better than a hybrid convergent
surgery or a pulsed field ablation. If the Maze surgery would be better in my case, BOTH the Mitral Valve, and the Afib
would be addressed robotically during the same robotic surgery. My question though is whether a pulsed field or
hybrid convergent method would be better, would it be in my best interest to just do the Robotic Mitral Repair,
and at a different time get a Pulsed Field Ablation or Hybrid Convergent Surgery?
Obviously I would prefer to address both issues at the same time, but if an ablation/hybrid convergent surgery would
be a better option then I am in no rush to do both surgeries at once. Any advice or suggestions on what would be the
best option would be appreciated. Thanks in advance.
Mitral Prolapse (Of the Posterior Leaflet). Many doctors totally disregarded my Echo's which showed this
moderate to Severe mitral regurgitation. Those cardiologists/EP's only stated to get an ablation. Fast forward
to now, my current Cardiologist and EP state they believe my AFIB is solely caused from the Severe Mitral
Regurgitation. My Ejection Fraction is 52%. All Chambers of my heart are excellent, except the Left Atria which
is severely enlarged. I was told the left atria is enlarged because of both the AFIB and the Mitral Regurgitation.
At any rate, it looks like i'm going to have the Minimally Invasive Robotic Mitral Valve Surgery. My Doctor said
at the same time, a Maze Procedure can be done to correct the AFIB. I have heard and read a little on Maze
Procedure before but can't find much info on whether a Maze procedure would be better than a hybrid convergent
surgery or a pulsed field ablation. If the Maze surgery would be better in my case, BOTH the Mitral Valve, and the Afib
would be addressed robotically during the same robotic surgery. My question though is whether a pulsed field or
hybrid convergent method would be better, would it be in my best interest to just do the Robotic Mitral Repair,
and at a different time get a Pulsed Field Ablation or Hybrid Convergent Surgery?
Obviously I would prefer to address both issues at the same time, but if an ablation/hybrid convergent surgery would
be a better option then I am in no rush to do both surgeries at once. Any advice or suggestions on what would be the
best option would be appreciated. Thanks in advance.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 05:45PM |
Registered: 10 years ago Posts: 2,519 |
I was diagnosed with Mitral Valve Prolapse in 1987. I was put on a beta blocker to keep my hr at 55. Cedar Sinai heart center didn’t want my hr higher. Fast forward to 2004 before my afib began.
Were you rx beta blockers for your MVP? I read somewhere that a low hr could trigger afib- if you were then perhaps your afib is not entirely from your valves.
I do see a family connection. Both my mom and I had mitral valve prolapse and both of us were on Tenormin.
Difficult to point blame because there could be many factors that initiates afib. It’s all a guess from genetic disposition to dehydration or other triggers that could had caused your first afib.
Were you rx beta blockers for your MVP? I read somewhere that a low hr could trigger afib- if you were then perhaps your afib is not entirely from your valves.
I do see a family connection. Both my mom and I had mitral valve prolapse and both of us were on Tenormin.
Difficult to point blame because there could be many factors that initiates afib. It’s all a guess from genetic disposition to dehydration or other triggers that could had caused your first afib.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 06:02PM |
Registered: 10 months ago Posts: 183 |
Hey Susan,
thanks for the response. There is nothing I can find that either of my parents or grandparents had any heart
issues at all, let alone with the Mitral Valve. Unfortunately, they have passed all due to different circumstances,
but nothing related to heart. I do know that in many cases the Mitral Valve Prolapse is hereditary, but in my case
it doesn't appear to be the case. Marfans syndrome has been completely ruled out as well.
At this point, I'm not so concerned on "why" I have it, I just have it and need to deal with it at this point.
The same with Afib. From what my EP said, i've been persistent for at least a year, possibly longer.
Looking back I had symptoms over the last few years but took it as being out of shape. That was until
the symptoms became worse and more common,and that's when I was diagnosed with Afib and Mitral
Valve Prolapse/Regurgitation a year ago. At this point, It looks certain I will be going with the Minimally
Invasive Robotic Surgery to address my Mitral Valve Repair of the Posterior Leaflets, and was told a
Maze procedure could be done during the same surgery to address the Afib and where the Left Atrial
Appendage is closed off?
I believe that was the terminology used. My question is whether or not the Maze procedure in my case
would be equally, less or more beneficial than just doing the Robotic Repair of the Mitral Valve by itself?
Would there are any reasons why it may be better to have a Pulsed Field or Hybrid Convergent Surgery done
at a later date or does it make more sense and would it more beneficial to address both the Mitral Valve Repair
and then the Maze Procedure during the same, robotic Surgery?
Edited 4 time(s). Last edit at 10/17/2023 06:04PM by cornerbax.
thanks for the response. There is nothing I can find that either of my parents or grandparents had any heart
issues at all, let alone with the Mitral Valve. Unfortunately, they have passed all due to different circumstances,
but nothing related to heart. I do know that in many cases the Mitral Valve Prolapse is hereditary, but in my case
it doesn't appear to be the case. Marfans syndrome has been completely ruled out as well.
At this point, I'm not so concerned on "why" I have it, I just have it and need to deal with it at this point.
The same with Afib. From what my EP said, i've been persistent for at least a year, possibly longer.
Looking back I had symptoms over the last few years but took it as being out of shape. That was until
the symptoms became worse and more common,and that's when I was diagnosed with Afib and Mitral
Valve Prolapse/Regurgitation a year ago. At this point, It looks certain I will be going with the Minimally
Invasive Robotic Surgery to address my Mitral Valve Repair of the Posterior Leaflets, and was told a
Maze procedure could be done during the same surgery to address the Afib and where the Left Atrial
Appendage is closed off?
I believe that was the terminology used. My question is whether or not the Maze procedure in my case
would be equally, less or more beneficial than just doing the Robotic Repair of the Mitral Valve by itself?
Would there are any reasons why it may be better to have a Pulsed Field or Hybrid Convergent Surgery done
at a later date or does it make more sense and would it more beneficial to address both the Mitral Valve Repair
and then the Maze Procedure during the same, robotic Surgery?
Edited 4 time(s). Last edit at 10/17/2023 06:04PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 07:35PM |
Admin Registered: 6 years ago Posts: 5,357 |
Pulsed field ablation (PFA) and Maze procedures (including a convergent procedure) are kind of apples and oranges. A PFA is just an ablation, nothing more. It uses a different technology that seems to be safer, but the end result is the same. But a Maze procedure is surgery and comes with all the attendant risks and a long recovery time, even the minimally invasive mini-Maze. A convergent is just a Maze procedure and ablation combined into a single procedure.
I'm not generally a fan of Maze procedures but if I had to undergo mitral valve repair anyway, I would go for the Maze procedure with LAA closure. I would save the ablation for later since you don't know for sure that you'll need it. With the LAA closure you'll reduce your stroke risk to about the same as people without afib even without anticoagulants, but the valve procedure will probably require them anyway.
I'm not generally a fan of Maze procedures but if I had to undergo mitral valve repair anyway, I would go for the Maze procedure with LAA closure. I would save the ablation for later since you don't know for sure that you'll need it. With the LAA closure you'll reduce your stroke risk to about the same as people without afib even without anticoagulants, but the valve procedure will probably require them anyway.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 08:10PM |
Registered: 4 years ago Posts: 735 |
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 08:22PM |
Registered: 10 months ago Posts: 183 |
Hey Carey,
you're always extremely informative, thank you. When you say you're not a fan of Maze procedures,
why is that? If I understand correctly, if I did an ablation at a later time, I would likely not need an
LAA Closure? My Mitral Regurgitation is severe as per my last 2 echos so I am getting the Mitral
Valve surgery. I'm curious why you aren't generally a fan of Maze procedures?
@Daisy (Susan) thank you that is great information. In the scenario you mentioned would I need
a watchman or similar device implanted if I decide to have the LAA closed or is there an LAA
surgery that doesn't need a device implanted?
Edited 1 time(s). Last edit at 10/17/2023 08:24PM by cornerbax.
you're always extremely informative, thank you. When you say you're not a fan of Maze procedures,
why is that? If I understand correctly, if I did an ablation at a later time, I would likely not need an
LAA Closure? My Mitral Regurgitation is severe as per my last 2 echos so I am getting the Mitral
Valve surgery. I'm curious why you aren't generally a fan of Maze procedures?
@Daisy (Susan) thank you that is great information. In the scenario you mentioned would I need
a watchman or similar device implanted if I decide to have the LAA closed or is there an LAA
surgery that doesn't need a device implanted?
Edited 1 time(s). Last edit at 10/17/2023 08:24PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 08:28PM |
Registered: 1 year ago Posts: 788 |
The LAA is often found to be involved in the electrically disordered regions, so it is often closed as part of an ablation. It might not be done during the 'index' operation, but if that procedure doesn't stem the AF, often the culprit is ultimately found to be in the LAA. Further, since the LAA might not have been closed, it's still a potential refuge for clot formation if the index ablation doesn't 'take'. That's why you should be on an anti-coagulant for life once you have been found to have AF, treated or not.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 08:29PM |
Registered: 4 years ago Posts: 735 |
Quote
cornerbax
@Daisy (Susan) thank you that is great information. In the scenario you mentioned would I need
a watchman or similar device implanted if I decide to have the LAA closed or is there an LAA
surgery that doesn't need a device implanted?
Nope, when they clip the LAA from the inside, like they would do during minimally invasive mitral valve repair, this is an alternative to a Watchman—nothing further needed.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 08:38PM |
Registered: 10 months ago Posts: 183 |
Quote
Nope, when they clip the LAA from the inside, like they would do during minimally invasive mitral valve repair, this is an alternative to a Watchman—nothing further needed.
Wow, there are so many different methods it's mind boggling. This is great to know.
You had Afib so did you decide to go through with the LAA closure and Mitral Valve
Repair WITHOUT a Maze procedure like you specified? If so, you did get an ablation
afterwards I assume, right?
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 09:06PM |
Registered: 4 years ago Posts: 735 |
Quote
cornerbax
Wow, there are so many different methods it's mind boggling. This is great to know.
You had Afib so did you decide to go through with the LAA closure and Mitral Valve
Repair WITHOUT a Maze procedure like you specified? If so, you did get an ablation
afterwards I assume, right?
I got a MitraClip, and then had an ablation with Dr. Natale and because of the long history with mitral valve disease, he had to isolate (ablate) the LAA in order to stop the Afib and flutter. This increases stroke risk as it reduces circulation in the LAA, so a few months later he implanted a Watchman. They can’t do it at the same time as the ablation as they have to let the inflammation heal. I don’t know whether after clipping the LAA there could be a scenario where they would need to isolate it in order to terminate Afib/flutter, but Carey would probably know. They don’t actually ablate inside the LAA, but rather the tissue around the mouth of it. I don’t know if that tissue would still be a problem after clipping. And I don’t know if a Maze procedure would address the issue either. Yes, lots of different methods.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 09:23PM |
Registered: 10 months ago Posts: 183 |
Quote
I got a MitraClip, and then had an ablation with Dr. Natale and because of the long history with mitral valve disease, he had to isolate (ablate) the LAA in order to stop the Afib and flutter. This increases stroke risk as it reduces circulation in the LAA, so a few months later he implanted a Watchman. They can’t do it at the same time as the ablation as they have to let the inflammation heal. I don’t know whether after clipping the LAA there could be a scenario where they would need to isolate it in order to terminate Afib/flutter, but Carey would probably know. They don’t actually ablate inside the LAA, but rather the tissue around the mouth of it. I don’t know if that tissue would still be a problem after clipping. And I don’t know if a Maze procedure would address the issue either. Yes, lots of different methods.
Again, very interesting. I'm just curious why you chose not to go with a Maze procedure at the time of your MitraClip?
The MitraClip I believe doesn't need a Lung Bypass Machine so I'm guessing your surgery wasn't as complex as the
Robotic Mitral Valve Surgery and that may be why you chose not to get a Maze procedure?
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 09:47PM |
Registered: 4 years ago Posts: 735 |
Quote
cornerbax
Again, very interesting. I'm just curious why you chose not to go with a Maze procedure at the time of your MitraClip?
The MitraClip I believe doesn't need a Lung Bypass Machine so I'm guessing your surgery wasn't as complex as the
Robotic Mitral Valve Surgery and that may be why you chose not to get a Maze procedure?
The MitraClip is not surgery, it is a transcatheter procedure with virtually no recovery time—overnight in the hospital just to be cautious then go home. The only recovery is the trivial healing of the femoral vein puncture. Maze is a whole different level as it actually is surgery and requires recovery. There is also a higher incidence of flutter after a Maze than after an ablation.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 10:07PM |
Registered: 10 months ago Posts: 183 |
Quote
The MitraClip is not surgery, it is a transcatheter procedure with virtually no recovery time—overnight in the hospital just to be cautious then go home. The only recovery is the trivial healing of the femoral vein puncture. Maze is a whole different level as it actually is surgery and requires recovery. There is also a higher incidence of flutter after a Maze than after an ablation.
Got it, and makes perfect sense. If Flutter has a higher incidence after a Maze, I'm thinking I may hold off on the Maze.
I will talk to my Doctor and ask all of the scenarios which most or all seem to of been mentioned here. I'm curious as to
what Carey's thoughts are on why he isn't a fan of Maze procedures as I'm in absolutely no rush and want the options
with the absolute best outcomes the first time around. I know nothing is 100% guaranteed, but I want to put myself
in a situation where I get the highest likelihood of reoccurrence or other issues post surgery.
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Re: Robotic Maze Surgery Vs. Ablation October 17, 2023 11:33PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
cornerbax
I'm curious why you aren't generally a fan of Maze procedures?
Because it's surgery with all the risks that come with surgery. And because it's surgery, there's a long, painful recovery period involved. Maze procedures very often resolve afib but put you into flutter, which isn't much better, so now you need an ablation to fix that when you could have just done an ablation in the first place and avoided the risk and pain of surgery. I only favor Maze when they're "going in there anyway so why not?"
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 06:40AM |
Registered: 10 months ago Posts: 183 |
[www.uchicagomedicine.org]
@Carey,
That makes perfect sense and I understand what you're saying. If I didn't have the
severe regurgitation that my EP and Cardiologist are certain is causing my Afib, I'd go
the Ablation route for sure and take all of your advice on a top ablationist to do the ablation.
Have you read the article I linked from Chicago medicine? I believe It has been posted on
this forum before. The article says many great things specifically on ROBOTIC MAZE
surgery.
I am curious if ROBOTIC Maze surgery is better than standard maze surgery through the chest
from a sternotomy? The article makes it seem that way. Another important thing to mention is my
cardiologist and EP are confident I've had long standing persistent afib. My overall Echo seem to
indicate that based on what they both said. This article from Chicago medicine points out this Robotic
Maze Surgery has such a great success rate for persistent and long standing persistent Afib which
would classify me. The article doesn't state anything on Flutter being a potential issue after the Robotic
Maze Surgery so do you think some how this Robotic Maze Surgery is better than the Standard Maze
Surgery or do you think flutter Is still a probability even with the Robotic Maze?
I don't know if this makes a difference but as i've mentioned on other posts, I am completely
Intolerant of Flecainide or any type 1C medication. I get extreme Flutter or even 1:1 conduction
from those medications. Do you think Flutter, should it occur from This Robotic Maze surgery would be
more significant for me knowing I already have issues with serious flutter from the Type 1C medications?
Edited 1 time(s). Last edit at 10/18/2023 04:05PM by cornerbax.
@Carey,
That makes perfect sense and I understand what you're saying. If I didn't have the
severe regurgitation that my EP and Cardiologist are certain is causing my Afib, I'd go
the Ablation route for sure and take all of your advice on a top ablationist to do the ablation.
Have you read the article I linked from Chicago medicine? I believe It has been posted on
this forum before. The article says many great things specifically on ROBOTIC MAZE
surgery.
I am curious if ROBOTIC Maze surgery is better than standard maze surgery through the chest
from a sternotomy? The article makes it seem that way. Another important thing to mention is my
cardiologist and EP are confident I've had long standing persistent afib. My overall Echo seem to
indicate that based on what they both said. This article from Chicago medicine points out this Robotic
Maze Surgery has such a great success rate for persistent and long standing persistent Afib which
would classify me. The article doesn't state anything on Flutter being a potential issue after the Robotic
Maze Surgery so do you think some how this Robotic Maze Surgery is better than the Standard Maze
Surgery or do you think flutter Is still a probability even with the Robotic Maze?
I don't know if this makes a difference but as i've mentioned on other posts, I am completely
Intolerant of Flecainide or any type 1C medication. I get extreme Flutter or even 1:1 conduction
from those medications. Do you think Flutter, should it occur from This Robotic Maze surgery would be
more significant for me knowing I already have issues with serious flutter from the Type 1C medications?
Edited 1 time(s). Last edit at 10/18/2023 04:05PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 10:24AM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
cornerbax
Do you think Flutter, should it occur from
This Robotic Maze surgery would be more significant
For me knowing I already have issues with serious flutter
From the Type 1C medications?
I don't know of any reason that would be true. All types of Maze procedures have a high incidence of flutter, which is why the Convergent procedure exists. The only thing the robot brings to the table is precision; otherwise, it's the same procedure as a mini-Maze performed by hand.
That article is pretty much a feel-good article about the good doctor and robotic Maze procedures, so of course they leave out the possible complications and only describe "a bit of soreness a week or two after the procedure." It's true that not many surgeons will do full Maze procedures requiring open heart (sternotomy) these days unless they're doing sternotomy for some other reason, mini-Maze procedures using robotics aren't as unusual as the article implies. Any type of Maze will probably resolve your afib, and if you're lucky it won't leave you with flutter instead, but just be aware that flutter is a pretty common complication that requires ablation to fix.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 01:49PM |
Registered: 4 years ago Posts: 735 |
Carey, unanswered question: if your LAA is clipped during a minimally invasive surgical repair of the Mitral Valve, is there tissue left around the mouth of the LAA that could be a source of arrhythmias and need ablation, or is that not a problem? As I understand it, when they ablate/isolate the LAA during an ablation, it is the tissue at the entrance that is ablated, rather than inside the LAA.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 04:09PM |
Registered: 10 months ago Posts: 183 |
Thank you again, Carey. This is something I have to ask regarding "Flutter" but the fact that an Ablation
(should flutter occur after the Maze) is great to know that at least there is an option after the surgery if
Flutter occurs. With this said is there ANY reasons you can think of where it may be more beneficial to
do the Robotic Mitral Valve Repair and an Ablation after and not do the Maze at the time of Mitral
Repair? I know you would not do a Maze if nothing else were being done but in my case you did suggest
considering the Maze as I have to have the Mitral Valve Repaired, anyway.
I'm just curious if you see any disadvantages (other than the surgery/recover time) with Maze where an
Ablation after the Mitral Repair would be more beneficial?
Edited 1 time(s). Last edit at 10/18/2023 04:53PM by cornerbax.
(should flutter occur after the Maze) is great to know that at least there is an option after the surgery if
Flutter occurs. With this said is there ANY reasons you can think of where it may be more beneficial to
do the Robotic Mitral Valve Repair and an Ablation after and not do the Maze at the time of Mitral
Repair? I know you would not do a Maze if nothing else were being done but in my case you did suggest
considering the Maze as I have to have the Mitral Valve Repaired, anyway.
I'm just curious if you see any disadvantages (other than the surgery/recover time) with Maze where an
Ablation after the Mitral Repair would be more beneficial?
Edited 1 time(s). Last edit at 10/18/2023 04:53PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 04:23PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Daisy
Carey, unanswered question: if your LAA is clipped during a minimally invasive surgical repair of the Mitral Valve, is there tissue left around the mouth of the LAA that could be a source of arrhythmias and need ablation, or is that not a problem? As I understand it, when they ablate/isolate the LAA during an ablation, it is the tissue at the entrance that is ablated, rather than inside the LAA.
Yes, they ablate around the opening and do not go inside the LAA. So I think it's still possible for the tissue surrounding the opening to be a source of afib or flutter, but obviously the rest of the LAA can't be since it's gone.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 06:18PM |
Registered: 8 months ago Posts: 35 |
I had mitral valve repair in 2021 with cryo maze procedure and LAA closure.
While my Afib was gone as a result, I soon started getting daily PACs and was put on Met+Flec. I strongly believe the maze procedure, for whatever reason, unleashed my PACs, cause I never had them this severe, daily.
Desperate, I reached out to Natale this yr and had an ablation with him 2 months ago. After 11 days of pure bliss, the PACs came back with a vengeance and tend to make an evening appearance every single day.
Next week it's time to wean off my meds and that'll be interesting to say the least. My prediction is that either the PACs will completely take over 24/7 and I go back to square 1, or perhaps there's a tiny tiny chance that with the meds gone I will actually start feeling better (tiny chance I know, but it has happened to others before).
We shall see....time will tell....
Edited 1 time(s). Last edit at 10/18/2023 06:19PM by WhyMe.
While my Afib was gone as a result, I soon started getting daily PACs and was put on Met+Flec. I strongly believe the maze procedure, for whatever reason, unleashed my PACs, cause I never had them this severe, daily.
Desperate, I reached out to Natale this yr and had an ablation with him 2 months ago. After 11 days of pure bliss, the PACs came back with a vengeance and tend to make an evening appearance every single day.
Next week it's time to wean off my meds and that'll be interesting to say the least. My prediction is that either the PACs will completely take over 24/7 and I go back to square 1, or perhaps there's a tiny tiny chance that with the meds gone I will actually start feeling better (tiny chance I know, but it has happened to others before).
We shall see....time will tell....
Edited 1 time(s). Last edit at 10/18/2023 06:19PM by WhyMe.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 06:49PM |
Registered: 10 months ago Posts: 183 |
Quote
I had mitral valve repair in 2021 with cryo maze procedure and LAA closure.
While my Afib was gone as a result, I soon started getting daily PACs and was put on Met+Flec. I strongly believe the maze procedure, for whatever reason, unleashed my PACs, cause I never had them this severe, daily.
Desperate, I reached out to Natale this yr and had an ablation with him 2 months ago. After 11 days of pure bliss, the PACs came back with a vengeance and tend to make an evening appearance every single day.
Next week it's time to wean off my meds and that'll be interesting to say the least. My prediction is that either the PACs will completely take over 24/7 and I go back to square 1, or perhaps there's a tiny tiny chance that with the meds gone I will actually start feeling better (tiny chance I know, but it has happened to others before).
We shall see....time will tell....
[/quote
This is definitely a huge concern as are the points Carey outlined. I don't want to drag this on forever but it's been an emotional rollercoaster.
Multiple Cardiologists/Ep's never said a word to me about my Mitral Valve Regurgitation after viewing my Echo's and only suggested an Ablation to correct the AFIB. Based on responses on this forum I reached out to Dr. Natale and had a video call with him a few months ago where he said to get my Mitral Valve checked FIRST before considering an Ablation. I am meeting with a Valve Specialist soon and should have remaining questions answered. My current Cardiologist and EP believe my AFIB is being caused from my Mitral Regurgitation, but I still haven't gotten complete certainty on that.
I definitely do NOT want a Valve Repair OR a Maze Procedure if there is a good enough likelihood I will develop regular PAC's and/or Atrial Flutter. I think at this point I need to know what dangers I would have if I did NOT get Mitral Repair Surgery right now and instead, opted for an Ablation. From my understanding there is a chance the Mitral Regurgitation could lessen with a successful Ablation and being back in NSR.
Key points to mention: From my Coronary CT SCAN all of my arteries have 0% Plaque and 0% Calcification. 2 Arteries, the RCA mid and LAD have 25-49% Plaque. I was told this is exceptional as my Calcium score is 0 and all of my arteries look exceptional. Apparently any of the Coronary Arteries would need to be 70% or more clogged to be concerning.
So my Coronary Arteries apparently are great, my Ejection Fraction is 50-52% based on my last 3 Echo's, all other Valves are excellent as is all Chambers of my heart EXCEPT the Left Atria which is severely dilated at 6.5CM. Apparently this is due to the AFIB and/or the Regurgitation.
With all of this said and the only concern is a LOW NORMAL on Ejection Fraction and a 35-50% Mitral Regurgitation, I'm wondering if I shouldn't just get an ablation for the AFIB FIRST, and keep an eye on the Valve after? Carey, what are your thoughts on this?
Anybody else have any suggestions?
Edited 1 time(s). Last edit at 10/18/2023 08:01PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 08:08PM |
Admin Registered: 6 years ago Posts: 5,357 |
I would not recommend disregarding Natale's advice. Mitral valve regurgitation trumps PACs and flutter. It probably explains your low-normal EF and improving that will improve everything else. PACs and flutter won't shorten your lifespan, but heart failure sure as hell will and a low-normal EF says you're headed in that direction.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 08:40PM |
Registered: 10 months ago Posts: 183 |
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I would not recommend disregarding Natale's advice. Mitral valve regurgitation trumps PACs and flutter. It probably explains your low-normal EF and improving that will improve everything else. PACs and flutter won't shorten your lifespan, but heart failure sure as hell will and a low-normal EF says you're headed in that direction.
Agreed and Understood and I definitely did not disregard Dr. Natale's advice which is why
I sought out specialists on the Mitral Regurgitation. My current Cardiologist believes my Afib
is a direct result from the Severe Mitral Regurgitation. I will know more within a few days after
I see a Valve Specialist who specialized in Robotic Valve Repair and has done thousands of
Mitral Valve Repairs, many of which involve the most common Posterior Leaflet like mine.
Carey, the last question I have is regarding the most important statement you've made. Heart
Failure is my biggest concern, so what area or areas OTHER than Ejection Fraction should be
heavily monitored? When Heart Failure occurs I would think that something on an Echo could
be viewed to be potentially detrimental just like Ejection Fraction. My first Echo was done in August
of 2022 and my EF was 53%. My current Echo done in September of this year, 2023 (over a year later)
and my EF is 51-52%. In a year it doesn't seem like my EF dropped much but I don't know how quickly
it can drop and I definitely don't want it dropping any more.
With that said, and with a relatively stable EF the last year, what other areas of my Echo could reflect
potential heart failure?
Edited 2 time(s). Last edit at 10/18/2023 08:42PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 08:55PM |
Registered: 8 months ago Posts: 35 |
I highly doubt it was may valve repair to cause the crazy PACs given up until last check my valve still looks good and my overall heart function is great, therefore I can only assume it was the actual maze procedure that unleashed my PACs.
Yes, obviously I am very happy they fixed my Afib and closed my appendage, but unfortunately in terms of symptoms, PACs feel just as annoying as a (slower) Afib episode to me. Therefore you can call them PACs, Afib or Mickey Mouse....if they feel the same, I am not a happy camper. I just want them gone.
Yes, obviously I am very happy they fixed my Afib and closed my appendage, but unfortunately in terms of symptoms, PACs feel just as annoying as a (slower) Afib episode to me. Therefore you can call them PACs, Afib or Mickey Mouse....if they feel the same, I am not a happy camper. I just want them gone.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 08:56PM |
Admin Registered: 6 years ago Posts: 5,357 |
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cornerbax
With that said, and with a relatively stable EF the last year, what other areas of my Echo could reflect
potential heart failure?
That's a bit out of my wheelhouse, but EF is the primary measure of HF and it's generally measured by echo, so I'd say regular echoes would be a good idea.
You also asked how fast it can happen. Although HF usually develops slowly over years, it can develop rapidly and by rapidly I mean months *. I knew a guy on another forum who went into HF after ignoring his tachycardia for months due to a miscommunication with his EP. I believe that only involved 2-3 months.
Anyway, bottom line is I would fix the valve first and worry about PACs and flutter after since the valve repair itself might help the PACs.
* HF can also develop in days or even hours due to serious illnesses and such, but that's not what we're talking about here.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 08:58PM |
Registered: 4 years ago Posts: 735 |
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cornerbax
I’m wondering if I shouldn't just get an ablation for the AFIB FIRST, and keep an eye on the Valve after? Carey, what are your thoughts on this?
Anybody else have any suggestions?
Or, get the valve repaired (my severe regurgitation was associated with heightened pulmonary pressure, which was concerning), and when well-recovered from surgery, get an ablation.
Edited 1 time(s). Last edit at 10/18/2023 10:12PM by Daisy.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 09:11PM |
Registered: 10 years ago Posts: 2,519 |
* HF can also develop in days or even hours due to serious illnesses and such, but that's not what we're talking about here.
Can I get HF if my upper chambers are beating >200-400 (PM download) although my ventricles are paced at 60? It still sounds like wear and tear and enlargement. I don’t think a heart is meant to take such pounding.
Can I get HF if my upper chambers are beating >200-400 (PM download) although my ventricles are paced at 60? It still sounds like wear and tear and enlargement. I don’t think a heart is meant to take such pounding.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 09:36PM |
Registered: 10 months ago Posts: 183 |
Thank you ALL for your great information and help. From everything stated, I don't want to play around with
regular Echo's and constantly think "what if" I did this or that. At this point, I'm sure it will be recommended
I move forward with the Robotic Mitral Valve Surgery and If so, I will. The only question is whether to
do the Robotic Maze Surgery at the same time or do the Mitral Valve Surgery as "Daisy" stated, recover,
and get an Ablation later.
I think with what Carey stated on many cases of Maze causing Flutter and where an ablation ends up being
needed anyway, I may just go that route. Obviously it's 2 procedures at 2 different times, but I am ok with that
as long as I give myself the best chance to have the least issues.
The Very last question I have is If I do the Ablation at a different time after the Robotic Mitral Valve Surgery,
should I still have the LAA closed off at the same time as the Mitral Valve surgery, or should that too wait until
later with an Ablation?
Edited 1 time(s). Last edit at 10/18/2023 09:37PM by cornerbax.
regular Echo's and constantly think "what if" I did this or that. At this point, I'm sure it will be recommended
I move forward with the Robotic Mitral Valve Surgery and If so, I will. The only question is whether to
do the Robotic Maze Surgery at the same time or do the Mitral Valve Surgery as "Daisy" stated, recover,
and get an Ablation later.
I think with what Carey stated on many cases of Maze causing Flutter and where an ablation ends up being
needed anyway, I may just go that route. Obviously it's 2 procedures at 2 different times, but I am ok with that
as long as I give myself the best chance to have the least issues.
The Very last question I have is If I do the Ablation at a different time after the Robotic Mitral Valve Surgery,
should I still have the LAA closed off at the same time as the Mitral Valve surgery, or should that too wait until
later with an Ablation?
Edited 1 time(s). Last edit at 10/18/2023 09:37PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 10:15PM |
Registered: 8 months ago Posts: 35 |
Another important point worth noting...if you are like me you are probably going to look for the best of the best when it comes to valve repair...which is what I did and he did a great job. So the million $ question is...can the best guy for the valve, also be the best at doing maze procedures? Probably not...and even if he is not the one doing it but one of his minions...the question is still the same...is that person the best? Which is why I went to Natale this time around for my regular ablation, and will return to him if I need a touch up to get rid of the PACs. Always go to the best of the best in that specific field. That's the only thing we can control. Everything else is in God's hands.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 10:18PM |
Registered: 4 years ago Posts: 735 |
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cornerbax
The Very last question I have is If I do the Ablation at a different time after the Robotic Mitral Valve Surgery,
should I still have the LAA closed off at the same time as the Mitral Valve surgery, or should that too wait until
later with an Ablation?
Get her clipped! I believe it is standard practice if one has Afib and is getting Robotic MitralValve Surgery, at least that was Dr. Trento’s (Cedars Sinai) initial plan for me before he decided that the MitraClip would be a better fit for me.
And to WhyMe’s point, Dr. Trento told me to get my valve repaired and then go to Natale for an ablation. And as for having the LAA “closed off” while having an ablation—it doesn’t really work like that. First there are a limited number of EPs who have the skill to isolate/ablate the LAA and they wouldn’t do it unless they saw that it was a source of arrhythmias. This is because 1) it takes a lot of skill and 2) ablating it doesn’t close it off but rather sets you up for a Watchman, which is another procedure that is done separately. Also, at this time, insurance only pays for a Watchman under certain circumstances, though that is likely to change.
Edited 1 time(s). Last edit at 10/18/2023 10:28PM by Daisy.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 10:55PM |
Registered: 10 months ago Posts: 183 |
@WHY ME,
You are 100% Right, and I learned this early on from Carey and other's on this forum...to get the BEST of the BEST
within their specialty. My Mitral Valve Repair would be with one of the very Best Robotic Valve Specialists with
Cedars Sinai. I do not know how many Robotic Maze Procedures they have done in relation to Robotic Valve
Repairs, but I will find that out.
@ Daisy,
thank you once again. That is very informative, makes perfect sense, and I do think I am leaning on doing the Ablation
at a later time. I guess the only downside is that I'd still be in AFIB after the Mitral Valve Repair Surgery, but the biggest
obstacle of the Mitral Valve Repair would be complete and that would be a huge weight lifted. I really wonder if there is
a chance that my heart could return to NSR on its own after the Mitral Valve Repair and with little to no regurgitation. Being
that my Cardiologist and EP have stated they believe my AFIB is "VALVULAR" and caused DIRECTLY by the Mitral Valve
Regurgitation, I wonder if there's a decent possibility NSR can be restored?
I'm thinking it probably isn't a great chance as I've had Persistent AFIB for at least a couple years, and I'm thinking it's
likely electric remodeling has already occurred, but wouldn't that be nice if NSR could be restored after the Mitral Prolapse
and Regurgitation is corrected?
Edited 2 time(s). Last edit at 10/18/2023 10:56PM by cornerbax.
You are 100% Right, and I learned this early on from Carey and other's on this forum...to get the BEST of the BEST
within their specialty. My Mitral Valve Repair would be with one of the very Best Robotic Valve Specialists with
Cedars Sinai. I do not know how many Robotic Maze Procedures they have done in relation to Robotic Valve
Repairs, but I will find that out.
@ Daisy,
thank you once again. That is very informative, makes perfect sense, and I do think I am leaning on doing the Ablation
at a later time. I guess the only downside is that I'd still be in AFIB after the Mitral Valve Repair Surgery, but the biggest
obstacle of the Mitral Valve Repair would be complete and that would be a huge weight lifted. I really wonder if there is
a chance that my heart could return to NSR on its own after the Mitral Valve Repair and with little to no regurgitation. Being
that my Cardiologist and EP have stated they believe my AFIB is "VALVULAR" and caused DIRECTLY by the Mitral Valve
Regurgitation, I wonder if there's a decent possibility NSR can be restored?
I'm thinking it probably isn't a great chance as I've had Persistent AFIB for at least a couple years, and I'm thinking it's
likely electric remodeling has already occurred, but wouldn't that be nice if NSR could be restored after the Mitral Prolapse
and Regurgitation is corrected?
Edited 2 time(s). Last edit at 10/18/2023 10:56PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 11:43PM |
Admin Registered: 6 years ago Posts: 5,357 |
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susan.d
Can I get HF if my upper chambers are beating >200-400 (PM download) although my ventricles are paced at 60? It still sounds like wear and tear and enlargement. I don’t think a heart is meant to take such pounding.
No. Heart failure is a ventricular problem, not atrial. Even if your atria are overworked and enlarged, that will not lead to HF.
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Re: Robotic Maze Surgery Vs. Ablation October 18, 2023 11:47PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 01:45AM |
Registered: 10 months ago Posts: 183 |
Carey,
So you are totally indifferent on
Whether to do the Maze while they
are in there vs no Maze and an ablation
Later? The occurrences of Flutter you
Mentioned is making me think it would
Be better to attack the AFIB at a
Later time but you did mention since
They're doing the mitral valve surgery
The Maze would be OK at the same time too.
This is really the only question remaining
As to what would be best. I'm leaning
Towards the ablation after.
So you are totally indifferent on
Whether to do the Maze while they
are in there vs no Maze and an ablation
Later? The occurrences of Flutter you
Mentioned is making me think it would
Be better to attack the AFIB at a
Later time but you did mention since
They're doing the mitral valve surgery
The Maze would be OK at the same time too.
This is really the only question remaining
As to what would be best. I'm leaning
Towards the ablation after.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 01:57AM |
Admin Registered: 6 years ago Posts: 5,357 |
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cornerbax
So you are totally indifferent on
Whether to do the Maze while they
are in there vs no Maze and an ablation
Later?
No, not at all. If a surgeon is going inside my chest, I want them to do everything surgical that needs doing. If I'm going to opt for the Maze, then do it with the valve surgery. Same with the LAA clipping. The ablation can wait for all that stuff because it might not even be needed and it's not surgical.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 12:59PM |
Registered: 10 months ago Posts: 183 |
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No, not at all. If a surgeon is going inside my chest, I want them to do everything surgical that needs doing. If I'm going to opt for the Maze, then do it with the valve surgery. Same with the LAA clipping. The ablation can wait for all that stuff because it might not even be needed and it's not surgical.
Thank you again, Carey. This makes perfect sense and because it's Robotic and my Doctor/Surgeon is apparently an
absolute master with the Robotics. I'm guessing the precision of the Maze would be exceptional. I will ask how many
Robotic MAZE procedures like mine they have done in relation to Robotic Mitral Valve repairs like mine. The only
question I have remaining is to just confirm that by doing the Robotic Mitral Valve repair, the LAA surgery and the
Robotic Maze procedure, is there ANY reason at all that should I have Afib or Aflutter after the Maze Surgery where
it would be WORSE for an ablation later than not doing the Maze at all?
You make more great points in that there's a much higher chance I won't have Afib after the Maze (I think it's around 90%
success where Afib never comes back after this Robotic Maze Surgery), but if I did have Afib or Aflutter after, would an
Ablation be compromised in ANY way to correct either Arrhythmia in the future?
Edited 2 time(s). Last edit at 10/19/2023 01:13PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 01:38PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 03:48PM |
Registered: 10 months ago Posts: 183 |
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 06:24PM |
Registered: 4 years ago Posts: 735 |
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cornerbax
Got it, and again thank you. I'm glad you also said the Mitral Regurg trumps AFIB/AFLUTTER, PACs, PVCs, etc.
It definitely puts things in perspective and again makes perfect sense. Thank you!
My local EP, Dr. Natale and Dr. Trento all said the same thing. When you watch severe regurgitation on an echo, you see why!
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 07:35PM |
Registered: 10 months ago Posts: 183 |
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My local EP, Dr. Natale and Dr. Trento all said the same thing. When you watch severe regurgitation on an echo, you see why!
I know i've said this on this forum before but it's absolutely incredible that 4 total hospital Cardiologists/EP's all disregarded
the Mitral Regurgitation on my Echo's and only said to get an Ablation. My EF and Regurgitation from my Echos over the
last year and a half have been nearly the same, so it really is scary that FOUR cardiologists/EP's didn't even MENTION IT.
Oddly enough, as I was being discharged, the Hospital General Physician mentioned that at "some point" I may need to
have my Mitral Valve "tightened", but that may be many years down the line. I told him none of the Cardiologists/EP's that
visited me mentioned anything about it and he said that it probably isn't as big of a concern "now" since it wasn't
mentioned. With the GREAT help of this FORUM and finding and Exceptional Cardiologist and EP, I now know
that an Ablation would of done little to nothing to correct my AFIB being that In my case my Afib is VALVULAR and
a direct cause of my Severe Mitral Regurgitation.
I know 1 or 2 Doctor's can miss things, but FOUR still absolutely perplexes me. It's really insane.
Edited 3 time(s). Last edit at 10/19/2023 08:06PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 07:58PM |
Registered: 4 years ago Posts: 735 |
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cornerbax
I know 1 or 2 Doctor's can miss things, but FOUR still absolutely perplexes me. It's really insane.
I agree that this is not very encouraging! After a couple of incidents like this, I have learned to try to read my own reports or ask people on the forum for help reading them.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 08:10PM |
Registered: 10 months ago Posts: 183 |
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I agree that this is not very encouraging! After a couple of incidents like this, I have learned to try to read my own reports or ask people on the forum for help reading them.
You are not kidding. I hate to think that those 4 Cardiologits/EP's only saw an open checkbook from my insurance
as my deductible had been met and everything at that point was 100% covered. I am very fortunate to have exceptional
health insurance and very thankful for it. I've never needed it in my LIFE until the last two years, and it really shows how
important it is. I do know that the 4 Cardiologists/EP's were really HEAVILY pushing the Ablation, and that none of them
do any kind of Valve Repair. It was being treated like a number with no concern for anything other than to do and charge
for an Ablation. I may be wrong, but I definitely feel that way.
Edited 1 time(s). Last edit at 10/19/2023 08:11PM by cornerbax.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 08:25PM |
Admin Registered: 6 years ago Posts: 5,357 |
I believe most doctors have good intentions, they want to help people, and they don't push patients into unnecessary or inappropriate treatments for the money. But they do get judged by metrics being collected on them by hospitals, Medicare, etc. You might be surprised by how little of those huge bills you see actually ends up in the doc's pocket. And, frankly, most of them don't even understand how billing works, what you paid, or who gets what. Doubt it? Ask those 4 docs what an ablation will cost. I doubt they have any idea.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 08:33PM |
Registered: 10 months ago Posts: 183 |
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Ask those 4 docs what an ablation will cost. I doubt they have any idea.
WOW! 2 of the 4 Doctor's were far more persistent on the Ablation than the other 2 but
they really all said "just get the ablation." And as mentioned NONE of them said a word
about the Mitral Regurgitation even though from Dr. Natale's professional view it was closer
to 50% Regurgitation. Dr. Natale viewed the same disc (I mailed it to him) that the 4 doctors
did, which is why it makes it even more perplexing.
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Re: Robotic Maze Surgery Vs. Ablation October 19, 2023 10:51PM |
Registered: 4 years ago Posts: 735 |
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cornerbax
WOW! 2 of the 4 Doctor's were far more persistent on the Ablation than the other 2 but
they really all said "just get the ablation." And as mentioned NONE of them said a word
about the Mitral Regurgitation even though from Dr. Natale's professional view it was closer
to 50% Regurgitation. Dr. Natale viewed the same disc (I mailed it to him) that the 4 doctors
did, which is why it makes it even more perplexing.
My EP had ignored the finding from an echo 2 years earlier that said moderate to severe regurgitation. It was Dr. Natale who called for a new echo after reading the report. The new echo showed severe regurgitation and that is when Natale said to get it repaired before having an ablation. Looking back, my EP should have kept on top of it and ordered a yearly echo as it was evident the the regurgitation was progressing.
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 12:32PM |
Registered: 5 years ago Posts: 192 |
I agree with others that getting everything done at the same time -- mitral valve repair, mini-maze, LAA closure -- makes the most sense. However, I would want to make sure the surgeon performing the procedures has done thousands of mini-maze's with a high success rate. Someone like Dr. Randall Wolf at Houston Methodist. He also works in conjunction with an ep, should catheter ablation be needed at a later date.
Jim
Jim
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 04:59PM |
Registered: 10 months ago Posts: 183 |
Jim, you are saying that an EP is there during the surgery of the Valve, LAA closure, andQuote
He also works in conjunction with an ep, should catheter ablation be needed at a later date.
Maze, even though my EP would not do the Maze procedure? I was told I should have between an
80-90% success rate with the Robotic Maze Procedure, where nothing would need to be done after,
but there is that 10-20% chance i'd need an Ablation at a later time.
You're saying the EP would still be there during the Robotic Surgeries?
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 05:05PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 05:09PM |
Registered: 5 years ago Posts: 192 |
No. He works well with an ep at the same hospital who would be available at a later date if needed. For example, in the case of typical right-sided flutter which the mini-maze cannot treat.
However, during a Hybrid/Convergent procedure, in some cases the ep will work alongside the cardiac surgeon during the same procedure. The surgeon from the outside. The ep from the inside. But at other institutions, the catheter work would be done at a later date. Hybrid/convergent has some similarities to mini maze, but the technique is different, so it's not the same as mini-maze plus a catheter based PVI.
Jim
However, during a Hybrid/Convergent procedure, in some cases the ep will work alongside the cardiac surgeon during the same procedure. The surgeon from the outside. The ep from the inside. But at other institutions, the catheter work would be done at a later date. Hybrid/convergent has some similarities to mini maze, but the technique is different, so it's not the same as mini-maze plus a catheter based PVI.
Jim
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 05:19PM |
Registered: 10 months ago Posts: 183 |
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 05:37PM |
Registered: 5 years ago Posts: 192 |
Quote
cornerbax
is there any way they could tell whether or not
a "HYBRID" procedure may be needed BEFORE the Maze?
If you're asking, should a Hybrid be done prior to a MiniMaze as part of a treatment plan, the answer is "No". Even with some similarities, they are two different procedures trying to accomplish the same thing. So, if you're going to do a MiniMaze, there would be no reason to have a Hybrid procedure before. It would be somewhat redundant and counter productive.
If you're asking, which procedure should you try first, it depends who you ask. Both have their advocates. It would be like asking whether rf or cryo is better. Both have their advocates.
Jim
Edited 1 time(s). Last edit at 10/24/2023 05:40PM by mjamesone.
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Re: Robotic Maze Surgery Vs. Ablation October 24, 2023 09:36PM |
Registered: 10 months ago Posts: 183 |
Quote
If you're asking, should a Hybrid be done prior to a MiniMaze as part of a treatment plan, the answer is "No". Even with some similarities, they are two different procedures trying to accomplish the same thing. So, if you're going to do a MiniMaze, there would be no reason to have a Hybrid procedure before. It would be somewhat redundant and counter productive.
If you're asking, which procedure should you try first, it depends who you ask. Both have their advocates. It would be like asking whether rf or cryo is better. Both have their advocates.
Jim
Thank you, this is what I figured and all responses on this have been the same which is to do the
Valve and Maze at the same time and an ablation later if needed. There are so many methods so
it's nice to know there are options but this seems like the best option in my situation. Thanks again.
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