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1. Extracorporeal membrane oxigenation in COVID-19 patients: Results of the ECMO-COVID Registry of the Spanish Society of Cardiovascular and Endovascular Surgery

Author

Castano, Mario, Sbraga, Fabrizio, Perez de la Sota, Enrique, Arribas, Jose M., Luisa Camara, M., Voces, Roberto, Donado, Alicia, Sandoval, Elena, Morales, Carlos A., Gonzalez-Santos, Jose M., Barquero-Aleman, Miguel, Fletcher-San Feliu, Delfina, Rodriguez-Roda, Jorge, Molina, Daniel, Bellido, Andre, Vigil-Escalera, Carlota, Tena, M. Angeles, Reyes, Guillermo, Gomez, Felix, Rivas, Jorge, Guevara, Audelio, Tauron, Manel, Miguel Borrego, Jose, Castillo, Laura, Miralles, Albert, Canovas, Sergio, Berastegui, Elisabet, Aramendi, Jose, I, Aldamiz, Gonzalo, Pruna, Robert, Silva, Jacobo, Saez de Ibarra, Jose I., Legarra, Juan J., Ballester, Carlos, Rodriguez-Lecoq, Rafael, Daroca, Tomas, Paredes, Federico, [Castano, Mario] Hosp Univ Leon, Serv Cirugia Cardiaca, Leon, Spain, [Castillo, Laura] Hosp Univ Leon, Serv Cirugia Cardiaca, Leon, Spain, [Sbraga, Fabrizio] Hosp Univ Bellvitge, Serv Cirugia Cardiaca, Lhospitalet De Llobregat, Spain, [Miralles, Albert] Hosp Univ Bellvitge, Serv Cirugia Cardiaca, Lhospitalet De Llobregat, Spain, [Perez de la Sota, Enrique] Hosp Univ 12 Octubre, Serv Cirugia Cardiaca, Madrid, Spain, [Arribas, Jose M.] Hosp Clin Univ Virgen de la Arrixaca, Serv Cirugia Cardiovasc, Murcia, Spain, [Canovas, Sergio] Hosp Clin Univ Virgen de la Arrixaca, Serv Cirugia Cardiovasc, Murcia, Spain, [Luisa Camara, M.] Hosp Badalona Germans Trias & Pujol, Serv Cirugia Cardiaca, Badalona, Spain, [Berastegui, Elisabet] Hosp Badalona Germans Trias & Pujol, Serv Cirugia Cardiaca, Badalona, Spain, [Voces, Roberto] Hosp Cruces, Serv Cirugia Cardiaca, Baracaldo, Spain, [Aramendi, Jose, I] Hosp Cruces, Serv Cirugia Cardiaca, Baracaldo, Spain, [Donado, Alicia] Fdn Jimenez Diaz, Serv Cirugia Cardiaca, Madrid, Spain, [Aldamiz, Gonzalo] Fdn Jimenez Diaz, Serv Cirugia Cardiaca, Madrid, Spain, [Donado, Alicia] Hosp Univ Rey Juan Carlos, Serv Cirugia Cardiaca, Mostoles, Spain, [Aldamiz, Gonzalo] Hosp Univ Rey Juan Carlos, Serv Cirugia Cardiaca, Mostoles, Spain, [Sandoval, Elena] Hosp Univ Clin Barcelona, Serv Cirugia Cardiovasc, Barcelona, Spain, [Morales, Carlos A.] Hosp Univ Cent Asturias, Serv Cirugia Cardiaca, Area Gest Clin Corazon, Oviedo, Spain, [Pruna, Robert] Hosp Univ Cent Asturias, Serv Cirugia Cardiaca, Area Gest Clin Corazon, Oviedo, Spain, [Silva, Jacobo] Hosp Univ Cent Asturias, Serv Cirugia Cardiaca, Area Gest Clin Corazon, Oviedo, Spain, [Gonzalez-Santos, Jose M.] Complejo Asistencial Univ Salamanca, Serv Cirugia Cardiaca, Salamanca, Spain, [Barquero-Aleman, Miguel] Hosp Univ Virgen Macarena, Serv Cirugia Cardiovasc, Seville, Spain, [Fletcher-San Feliu, Delfina] Hosp Univ Son Espases, Serv Cirugia Cardiaca, Palma De Mallorca, Spain, [Saez de Ibarra, Jose I.] Hosp Univ Son Espases, Serv Cirugia Cardiaca, Palma De Mallorca, Spain, [Rodriguez-Roda, Jorge] Hosp Univ Ramon y Cajal, Serv Cirugia Cardiaca, Madrid, Spain, [Molina, Daniel] Hosp Alvaro Cunqueiro, Serv Cirugia Cardiaca, Vigo, Spain, [Legarra, Juan J.] Hosp Alvaro Cunqueiro, Serv Cirugia Cardiaca, Vigo, Spain, [Bellido, Andre] Hosp Univ Miguel Servet, Serv Cirugia Cardiaca, Zaragoza, Spain, [Ballester, Carlos] Hosp Univ Miguel Servet, Serv Cirugia Cardiaca, Zaragoza, Spain, [Vigil-Escalera, Carlota] Hosp Univ Vall Hebron, Serv Cirugia Cardiaca, Barcelona, Spain, [Rodriguez-Lecoq, Rafael] Hosp Univ Vall Hebron, Serv Cirugia Cardiaca, Barcelona, Spain, [Tena, M. Angeles] Hosp Dr Negrin, Serv Cirugia Cardiaca, Las Palmas Gran Canaria, Spain, [Paredes, Federico] Hosp Dr Negrin, Serv Cirugia Cardiaca, Las Palmas Gran Canaria, Spain, [Reyes, Guillermo] Hosp Univ La Princesa, Serv Cirugia Cardiaca, Madrid, Spain, [Gomez, Felix] Complejo Hosp Navarra, Serv Cirugia Cardiaca, Pamplona, Spain, [Rivas, Jorge] Hosp Univ Quironsalud Madrid, Serv Cirugia Cardiaca, Pozuelo De Alarcon, Spain, [Guevara, Audelio] Hosp Univ & Politecn La Fe, Serv Cirugia Cardiaca, Valencia, Spain, [Tauron, Manel] Hosp Santa Creu & Sant Pau, Serv Cirugia Cardiaca, Barcelona, Spain, [Miguel Borrego, Jose] Hosp Univ Puerta Mar, Serv Cirugia Cardiaca, Cadiz, Spain, [Daroca, Tomas] Hosp Univ Puerta Mar, Serv Cirugia Cardiaca, Cadiz, Spain, and [Paredes, Federico] Hosp Univ Virgen del Rocio, Serv Cirugia Cardiaca, Seville, Spain

Subjects
Extracorporeal membrane oxygenation, Oxygenation, Respiratory-distress-syndrome, Failure, COVID-19, Heart failure, ECMO, Respiratory failure, Support, Guidelines, Trial
Abstract

Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO.Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge.Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 +/- 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence.Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. (C) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.

Published
2022

2. Análisis del remodelado anatomoeléctrico auricular para la predicción del éxito de la ablación quirúrgica concomitante de la fibrilación auricular a largo plazo

Author

Universitat Politècnica de València. Grupo de ingeniería en bioseñales e imagen radiológica, Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica, Universitat Politècnica de València. Escuela Politécnica Superior de Gandia - Escola Politècnica Superior de Gandia, Martin, Elio, Hornero, Fernando, Rieta, J J, Hernández Alonso, Antonio, Paredes, Federico, Mena, Armando, Gil, Oscar, Canovas, Sergio, Garcia, Rafael, Martinez Leon, Juan, Universitat Politècnica de València. Grupo de ingeniería en bioseñales e imagen radiológica, Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica, Universitat Politècnica de València. Escuela Politécnica Superior de Gandia - Escola Politècnica Superior de Gandia, Martin, Elio, Hornero, Fernando, Rieta, J J, Hernández Alonso, Antonio, Paredes, Federico, Mena, Armando, Gil, Oscar, Canovas, Sergio, Garcia, Rafael, and Martinez Leon, Juan

Abstract

[EN] Objective: To identify preoperative parameters of anatomo-electrical atrial remodelling in order to identify the subgroup of patients more favourable to long-term sinus rhythm (SR) re-establishment after concomitant ablation of persistent-permanent atrial fibrillation (AF). Methods: The study included 50 consecutive patients undergoing concomitant surgical ablation of persistent-permanent AF with cryoablation and bipolar radiofrequency Maze IV pattern. The variables collected before the operation were: demographic variables, morbidity, AF evolution time, transthoracic echocardiographic study, and digital electrocardiogram register for f-wave signal organisation analysis (sample entropy [SampEn]). An assessment was also made of the individual and combined association of atrial remodelling parameters with SR restoration by area under ROC curve (AUC). Results: Follow-up 22.32 +/- 3.19 months. Mean AF onset time 4.00 +/- 4.28 years. Mean left atrium diameter 49.90 +/- 8.18 mm (range = 32 - 81 mm), and SR restoration of 62% at the end of follow-up. Parameters best linked to postoperative SR restoration were left atrium diameter (AUC = 0.848)and SampEn (AUC = 0.845). Cut-off points were 50 mm and 0.0857, respectively, obtaining a model with a predictive accuracy when both parameters combined with an AUC = 0.893. Conclusions: Preoperative anatomo-electrical remodelling analysis through indirect non-nvasive variables could be useful to select patients more favourable to SR restoration after concomitant ablation of AF., [ES] Objetivo: Identificación de parámetros de remodelado auricular anatomoeléctrico preoperatorios que permitan seleccionar un subgrupo de pacientes favorable al restablecimiento del ritmo sinusal (RS) a largo plazo tras ablación quirúrgica concomitante de fibrilación auricular (FA) persistente-permanente. Métodos: Cincuenta pacientes consecutivos sometidos a ablación quirúrgica concomitante de FA persistente-permanente por patrón Maze IV mediante crioblación y radiofrecuencia bipolar. Preoperatorio: se consideraron variables demográficas, morbilidad, tiempo de evolución de FA, estudio de ecocardiografía transtorácica y registro de electrocadiograma digital para análisis de organización de señal de ondas f (entropía muestral [SampEn]). Valoración de la asociación individual y conjunta de los parámetros de remodelado auricular con la restauración de RS mediante área bajo la curva ROC (ABC). Resultados: Seguimiento medio 22,32 ± 3,19 meses. Tiempo medio de evolución de FA 4,00 ± 4,28 años. Diámetro auricular izquierdo medio 49,90 ± 8,18 mm (rango = 32–81 mm). Restauración RS 62% al cierre del seguimiento. Los parámetros que mejor se asociaron con la restauración de RS postoperatorio fueron el diámetro auricular izquierdo (ABC = 0,848) y SampEn (ABC = 0,845). Hallados puntos de corte para ambos en 50 mm y 0,0857, respectivamente; se obtuvo un modelo con capacidad predictiva ABC = 0,893. Conclusiones: El análisis del grado de remodelado auricular anatomoeléctrico preoperatorio mediante variables indirectas incruentas podría ser útil para seleccionar los pacientes más favorables para el restablecimiento de RS tras ablación concomitante de FA.

Published
2016

3. Impact of COVID-19 on the cardiovascular surgery departments in Spain: Analysis of the diagnostic-related groups (SECCE-COVID-19 Study phase 2)

Author

Rodriguez-Caulo E, Villaescusa J, Hernandez-Vaquero D, Aldamiz-Echevarria G, Bustamante-Munguira J, Carnero-Alcazar M, Berastegui E, Sbraga F, Gonzalez-Santos J, Jimenez J, Gutierrez E, Lopez-Gude M, Laguna G, Valderrama-Marcos J, Juarez C, Irabien A, Ventosa-Fernandez G, Margarit J, Gracia-Baena J, Canovas S, Sadaba R, Gonzalez-Barbeito M, Campos E, Barquero-Aroca J, Grp Estudio SECCE-COVID-19, [Andres Rodriguez-Caulo, Emiliano] Hosp Univ Virgen Macarena, Serv Cirugia Cardiovasc, Seville, Spain, [Miguel Barquero-Aroca, Jose] Hosp Univ Virgen Macarena, Serv Cirugia Cardiovasc, Seville, Spain, [Manuel Villaescusa, Jose] Univ Malaga, Hosp Univ Virgen Victoria, Serv Cirugia Cardiovasc, Malaga, Spain, [Hernandez-Vaquero, Daniel] Hosp Univ Cent Asturias, Serv Cirugia Cardiovasc, Oviedo, Spain, [Aldamiz-Echevarria, Gonzalo] Fdn Jimenez Diaz & Hosp Rey Juan Carlos, Serv Cirugia Cardiovasc, Madrid, Spain, [Bustamante-Munguira, Juan] Univ Valladolid, Serv Cirugia Cardiaca, Hosp Clin, Valladolid, Spain, [Carnero-Alcazar, Manuel] Hosp Clin San Carlos, Serv Cirugia Cardiovasc, Madrid, Spain, [Berastegui, Elisabeth] Hosp Badalona Germans Trias & Pujol, Serv Cirugia Cardiovasc, Barcelona, Spain, [Sbraga, Fabrizio] Hosp Univ Bellvitge, Serv Cirugia Cardiaca, Barcelona, Spain, [Maria Gonzalez-Santos, Jose] Hosp Univ Salamanca, Serv Cirugia Cardiovasc, Salamanca, Spain, [Garrido Jimenez, Jose Manuel] Hosp Univ Virgen de las Nieves, Serv Cirugia Cardiovasc, Granada, Spain, [Gutierrez, Encarnacion] Hosp Univ Virgen del Rocio, Serv Cirugia Cardiovasc, Seville, Spain, [Jesus Lopez-Gude, Maria] Hosp Univ 12 Octubre, Serv Cirugia Cardiovasc, Madrid, Spain, [Laguna, Gregorio] Univ Leon, Serv Cirugia Cardiovasc, Hosp Clin, Leon, Spain, [Francisco Valderrama-Marcos, Jose] Hosp Reg Univ Malaga, Serv Cirugia Cardiovasc, Malaga, Spain, [Juarez, Carlos] Hosp Univ Marques de Valdecilla, Serv Cirugia Cardiovasc, Santander, Spain, [Irabien, Angela] Hosp Rambla, Serv Cirugia Cardiovasc, Santa Cruz De Tenerife, Spain, [Ventosa-Fernandez, Guillermo] Hosp Univ Son Espases, Serv Cirugia Cardiovasc, Palma De Mallorca, Spain, [Antonio Margarit, Juan] Hosp Ribera, Serv Cirugia Cardiovasc, Alzira, Spain, [Manuel Gracia-Baena, Juan] Univ Valencia, Serv Cirugia Cardiovasc, Hosp Clin, Valencia, Spain, [Canovas, Sergio] Hosp Univ Virgen de la Arrixaca, Serv Cirugia Cardiovasc, Murcia, Spain, [Sadaba, Rafael] Complejo Hosp Navarra, Serv Cirugia Cardiaca, Pamplona, Spain, [Gonzalez-Barbeito, Miguel] Hosp Univ Doctor Negrin, Serv Cirugia Cardiovasc, Las Palmas Gran Canaria, Spain, and [Campos, Elena] Univ Valencia, Serv Cirugia Cardiovasc, Hosp Gen, Valencia, Spain

Subjects
Impact, SARS-CoV-2, COVID-19, Surgery
Abstract

Introduction and objectives: The COVID-19 pandemic caused by the SARS-CoV-2 virus infection has saturated the Spanish health system, affecting the care of cardiovascular diseases. In this phase 2 of the SECCE-COVID-19 study we want to quantify the impact of the pandemic on the number of cardiac surgeries by analyzing the most prevalent diagnostic-related groups (DRGs) in our specialty. Methods: At the request of the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE), all the centers in the national territory that wanted to participate were asked for the data of the DRG codes number 162 (surgery on heart valves with infarction or complex diagnosis), 163 (surgery on heart valves without infarction or complex diagnosis), 165 (coronary bypass with infarction or complex diagnosis), 166 (coronary bypass without infarction or complex diagnosis) and 167 (other cardiothoracic or thoracic vascular procedures) between March 1, 2020 and September 30, 2020 (7 months), and as a control period the same dates of the year 2019. Results: Data were received from 24 Hospital Centers, 22 public and 2 private. There was a global decrease in the number of interventions of 30% (Range -19 a -42%, p < 0.001) from 4648 in 2019 to 3262 in 2020 (-1386 difference), being +7% for the GRD 162 (p = 0.500), -37% for 163 (p = 0.001), -9% for 165(p = 0,304), -32% for 166 (p = 0.001) and -16% for 167(p = 0.062). Conclusions: There was a statistical significant global decrease in surgeries in 2020 of 30% compared to 2019 between March 1 and September 30. (C) 2021 Sociedad Espafiola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.

Published
2021

4. Spanish experience with heart transplants from controlled donation after the circulatory determination of death using thoraco-abdominal normothermic regional perfusion and cold storage.

Author

Miñambres E, Royo-Villanova M, Pérez-Redondo M, Coll E, Villar-García S, Canovas SJ, Francisco Nistal J, Garrido IP, Gómez-Bueno M, Cobo M, and Dominguez-Gil B

Subjects
Death, Humans, Organ Preservation, Perfusion, Tissue Donors, Young Adult, Heart Transplantation, Tissue and Organ Procurement
Abstract

Heart transplantation from controlled donation after the circulatory determination of death (cDCDD) may help to increase the availability of hearts for transplantation. During 2020, four heart transplants were performed at three different Spanish hospitals based on the use of thoraco-abdominal normothermic regional perfusion (TA-NRP) followed by cold storage (CS). All donors were young adults <45 years. The functional warms ischemic time ranged from 8 to 16 minutes. In all cases, the heart recovered sinus rhythm within 1 minute of TA-NRP. TA-NRP was weaned off or decreased <1L within 25 minutes. No recipient required mechanical support after transplantation and all were immediately extubated and discharged home (median hospital stay: 21 days) with an excellent outcome. Four livers, eight kidneys, and two pancreata were also recovered and transplanted. All abdominal grafts recipients experienced an excellent outcome. The use of TA-NRP makes heart transplantation feasible and allows assessing heart function before organ procurement without any negative impact on the preservation of abdominal organs. The use of TA-NRP in cDCDD heart donors in conjunction with cold storage following retrieval can eliminate the need to use ex situ machine perfusion devices, making cDCDD heart transplantation economically possible in other countries., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Published
2021
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5. The impact of calcium volume and distribution in aortic root injury related to balloon-expandable transcatheter aortic valve replacement.

Author

Hansson NC, Nørgaard BL, Barbanti M, Nielsen NE, Yang TH, Tamburino C, Dvir D, Jilaihawi H, Blanke P, Makkar RR, Latib A, Colombo A, Tarantini G, Raju R, Wood D, Andersen HR, Ribeiro HB, Kapadia S, Min J, Feuchtner G, Gurvitch R, Alqoofi F, Pelletier M, Ussia GP, Napodano M, Sandoli de Brito F Jr, Kodali S, Pache G, Canovas SJ, Berger A, Murphy D, Svensson LG, Rodés-Cabau J, Leon MB, Webb JG, and Leipsic J

Subjects
Aged, Aged, 80 and over, Aortic Diseases diagnosis, Aortic Valve diagnostic imaging, Aortic Valve injuries, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnosis, Aortography methods, Calcinosis complications, Calcinosis diagnosis, Cardiac Catheterization methods, Case-Control Studies, Female, Heart Injuries diagnosis, Heart Valve Prosthesis Implantation methods, Humans, Male, Multidetector Computed Tomography, Predictive Value of Tests, Risk Assessment, Risk Factors, Severity of Illness Index, Treatment Outcome, Vascular Calcification diagnosis, Vascular System Injuries diagnosis, Aortic Diseases complications, Aortic Valve pathology, Aortic Valve Stenosis therapy, Calcinosis therapy, Cardiac Catheterization adverse effects, Heart Injuries etiology, Heart Valve Prosthesis Implantation adverse effects, Kyphoplasty adverse effects, Vascular Calcification complications, Vascular System Injuries etiology
Abstract

Background: A detailed assessment of calcium within the aortic root may provide important additional information regarding the risk of aortic root injury during transcatheter heart valve replacement (TAVR)., Objective: We sought to delineate the effect of calcium volume and distribution on aortic root injury during TAVR., Methods: Thirty-three patients experiencing aortic root injury during TAVR with a balloon-expandable valve were compared with a control group of 153 consecutive TAVR patients without aortic root injury (as assessed by post-TAVR multidetector CT). Using commercial software to analyze contrast-enhanced pre-TAVR CT scans, calcium volume was determined in 3 regions: (1) the overall left ventricular outflow tract (LVOT), extending 10 mm down from the aortic annulus plane; (2) the upper LVOT, extending 2 mm down from the annulus plane; and (3) the aortic valve region., Results: Calcium volumes in the upper LVOT (median, 29 vs 0 mm(3); P < .0001) and overall LVOT (median, 74 vs 3 mm(3); P = .0001) were higher in patients who experienced aortic root injury compared with the control group. Calcium in the aortic valve region did not differ between groups. Upper LVOT calcium volume was more predictive of aortic root injury than overall LVOT calcium volume (area under receiver operating curve [AUC], 0.78; 95% confidence interval, 0.69-0.86 vs AUC, 0.71; 95% confidence interval, 0.62-0.82; P = .010). Upper LVOT calcium below the noncoronary cusp was significantly more predictive of aortic root injury compared to calcium underneath the right coronary cusp or the left coronary cusp (AUC, 0.81 vs 0.68 vs 0.64). Prosthesis oversizing >20% (likelihood ratio test, P = .028) and redilatation (likelihood ratio test, P = .015) improved prediction of aortic root injury by upper LVOT calcium volume., Conclusion: Calcification of the LVOT, especially in the upper LVOT, located below the noncoronary cusp and extending from the annular region, is predictive of aortic root injury during TAVR with a balloon-expandable valve., (Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Published
2015
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6. Intraoperative cryoablation of atrial fibrillation with the old-fashioned cryode tips: a simple, effective, and inexpensive method.

Author

Hornero F, Rodríguez I, Estevez V, Vázquez A, Gil O, Canovas S, García Fuster R, and Martínez-León J

Subjects
Atrial Fibrillation diagnosis, Catheter Ablation economics, Catheter Ablation instrumentation, Cost-Benefit Analysis, Cryosurgery economics, Cryosurgery methods, Equipment Design, Female, Follow-Up Studies, Humans, Intraoperative Care methods, Male, Retrospective Studies, Risk Assessment, Surgical Equipment economics, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation methods, Cryosurgery instrumentation
Abstract

Nowadays atrial fibrillation is usually treated simultaneously with cardiac procedures, and new cryo-systems have been developed for performing easier and faster intraoperative ablation. However, the old cryode designs can still be useful in surgical practice and represent a more cost-effective method. In this article we present a technique using old-fashioned cryodes for intraoperative treatment of atrial fibrillation and comment on its advantages and limitations.

Published
2007
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