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Early outcomes of usage of cryoFORM® probe for cryomaze procedure in congenital heart surgery

Part of: Tetralogy of Fallot (TOF) Surgery Electrophysiology

Published online by Cambridge University Press:  29 September 2020

Firat H. Altin Open the ORCID record for Firat H. Altin [Opens in a new window] ,
Sevket Balli ,
Murat Cicek ,
Okan Yurdakok ,
Oktay Korun ,
Ahmet Sasmazel  and
Numan A. Aydemir
Firat H. Altin*
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Sevket Balli
Affiliation:
Paediatric Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Murat Cicek
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yurdakok
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Oktay Korun
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Ahmet Sasmazel
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Numan A. Aydemir
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Firat H. Altin, Tibbiye Cad. No:13 Uskudar, Istanbul, Turkey34668. Tel: + 90 (216) 542 44 44; Fax: + 90 (216) 418 96 49. E-mail: [email protected]
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Abstract

Objectives:

This study aimed to evaluate the early outcomes of patients who underwent a concomitant therapeutic maze procedure for congenital heart surgery.

Materials and Methods:

Between 2019 and 2020, eight patients underwent surgical cryoablation by using the same type of cryoablation probe.

Results:

Three patients had atrial flutter, two had Wolf–Parkinson–White syndrome, two intra-atrial reentrant tachycardia, and one had atrial fibrillation. Four patients underwent electrophysiological study. Preoperatively, one patient was on 3, two were on 2, five were on 1 antiarrhythmic drug. Six patients underwent right atrial maze and two underwent bilateral atrial maze. Five out of six right atrial maze patients underwent right atrial reduction. Nine different lesion sets were used. Some of the lesions were combined and applied as one lesion. In Ebstein’s anomaly patients, the lesion from coronary sinus to displaced tricuspid annulus was delicately performed. The single ventricle patient with heterotaxy had junctional rhythm at the time of discharge and was the only patient who experienced atrial extrasystoles 2 months after discharge. Seven of the eight patients were on sinus rhythm. No patient needed permanent pacemaker placement.

Conclusion:

Cryomaze procedure can be applied in congenital heart diseases with acceptable arrhythmia-free rates by selecting the appropriate materials and suitable lesion sets. The application of cryomaze in heterotaxy patients can be challenging due to differences in the conduction system and complex anatomy. Consensus with the electrophysiology team about the choice of the right–left or biatrial maze procedure is mandatory for operational success.

Keywords

Arrhythmiacongenital heart diseasecryoablationmaze procedurecardiac surgery
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1874 - 1879
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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