Freezing Equals Freezing? Performance of Two Cryoablation Devices in Concomitant Mitral Valve Repair

Goette, Julia; Weimar, Timo; Vosseler, Martina; Raab, M.; Czesla, Markus; Doll, Nicolas

doi:10.1055/s-0035-1563537

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…However, does the efficacy of a colder cryoprobe change the rhythm outcomes? An observational study, with all its biases, reported better rhythm outcomes for the nitrous oxide probe compared to the argon one ( 46 ). In contrast, a recent randomized controlled trial showed no significant difference between the two probes at 1- ( 47 ) and 5-year ( 48 ) follow-up.…”

Section: Energy Sourcesmentioning

confidence: 99%

Surgical options for atrial fibrillation treatment during concomitant cardiac procedures

Baudo,

Rosati,

Lapenna

et al. 2024

Ann Cardiothorac Surg

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Current guidelines recommend concomitant surgical ablation (SA) of atrial fibrillation (AF) in the context of mitral valve disease. A variety of energy sources have been tested for SA to perform effective transmural lesions reliably. To date, only radiofrequency and cryothermy energies are considered viable options. The gold standard for SA is the Cox-Maze ablation set, especially for non-paroxysmal AF (nPAF), with the aim of interrupting macro-reentrant drivers perpetuating AF, without hampering the sinus node activation of both atria, and to maintain the atrioventricular synchrony. Although the efficacy of SA in terms of early and late sinus rhythm restoration has been clearly demonstrated over the years, concomitant AF ablation is still underperformed in patients with AF undergoing cardiac surgery. From a surgical standpoint, concerns have been raised about whether a single (left) or double atriotomy would be justified in AF patients undergoing a “non-atriotomy” surgical procedure, such as aortic valve or revascularization surgery. Thus, an array of simplified lesion sets have been described in the last decade, which have unavoidably hampered procedural efficacy, somewhat jeopardizing the standardization process of ablation surgery. As a matter of fact, the term “Maze” has improperly become a generic term for SA. Surgical interventions that do not align with the principles of forming conduction-blocking lesions according to the Maze pattern, cannot be classified as Maze procedures. In this complex scenario, a tailored approach according to the different AF patterns has been proposed: for patients with concomitant nPAF, a biatrial Cox-Maze ablation is recommended. Conversely, it might be reasonable to limit lesions to the left atrium or the pulmonary veins in patients with paroxysmal AF (PAF) in some clinical scenarios. The aim of this review is to provide an overview of the current ablation strategies for patients with AF undergoing concomitant cardiac surgery.

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Section: Energy Sourcesmentioning

confidence: 99%

Surgical options for atrial fibrillation treatment during concomitant cardiac procedures

Baudo,

Rosati,

Lapenna

et al. 2024

Ann Cardiothorac Surg

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“…Therefore, high thermal conductivity of the material chosen for an applicator plays significant role. Due to this, common applicators are made of metals [38][39][40][41]. At the same time, sapphire features high thermal conductivity at cryogenic temperatures, that along with the mentioned properties makes it a favorable material for cryosurgery [42].…”

Section: Introductionmentioning

confidence: 99%

Manufacturing of Sapphire Crystals with Variable Shapes for Cryosurgical Applications

Dolganova,

Zotov,

Rossolenko

et al. 2024

Crystals

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Consideration of sapphire shaped crystals as the material for manufacturing of medical instruments expands the opportunities of various approaches for diagnostics, exposure and treatment. Due to physical, mechanical and chemical properties of sapphire, as well as to its complex shape, such instruments are capable to demonstrate better performance for medical applications comparing to common tools. However, the manufacturing of high quality sapphire crystal with such geometry is still a complex issue, that usually requires application of various crystal growth techniques assisted with the automated weight control system. In this work, we consider one of such cases, that is the growth of a sapphire crystal, which can be applied for cryosurgery as an applicator due to a hollow-monolithic shape transition. Its hollow part can be filled with coolant in order to enable fast freezing of biological tissue during application. For this aim, it is of high importance to exclude the appearance of inclusions during the shape transition. To overcome this problem, we suggest using of noncapillary shaping (NCS) technique of crystal growth and study the weight signal measured during the manufacturing. We obtain the analytical description of the weight signal alteration that can be used as the program equation to control the crystal shape. We experimentally demonstrate the advantage of using such crystal for cryosurgery and obtaining faster ice-ball formation inside the model gelatin-based medium in comparison with the usage of the monolithic sapphire applicator of the same diameter. The demonstrated ability can be applied for future development of cryosurgical tools, while the analytical description of the weight signal could find its application for NCS manufacturing of sapphire crystals for other purposes.

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Freezing Equals Freezing? Performance of Two Cryoablation Devices in Concomitant Mitral Valve Repair

Cited by 2 publications

References 19 publications

Surgical options for atrial fibrillation treatment during concomitant cardiac procedures

Surgical options for atrial fibrillation treatment during concomitant cardiac procedures

Manufacturing of Sapphire Crystals with Variable Shapes for Cryosurgical Applications

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