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J Thorac Cardiovasc Surg 2001;122:1239-1240
© 2001 The American Association for Thoracic Surgery
Brief Communications |
From the Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio.
Received for publication May 31, 2001. Accepted for publication June 12, 2001. Address for reprints: A. Marc Gillinov, MD, Department of Thoracic and Cardiovascular Surgery/F24, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195 (E-mail: gillinom@ccf.org).
Recent reports document successful operative treatment of atrial fibrillation by radiofrequency ablation of the left atrium.
1 We report the case of a patient with rheumatic mitral valve disease and chronic atrial fibrillation who had a fatal esophageal injury during radiofrequency ablation of the left atrium.
Clinical summary
A 60-year-old woman with rheumatic mitral valve disease and chronic atrial fibrillation of several years' duration came for surgical evaluation. The patient was small and cachectic, with a weight of 29 kg, a height of 146 cm, and a body surface area of 1.07 m2. Transesophageal echocardiography demonstrated normal left and right ventricular function, biatrial enlargement (maximum left atrial diameter 7.0 cm), 2+ mitral regurgitation, and severe mitral stenosis.
She was taken to the operating room on April 30, 2001. A transesophageal echocardiogram was performed, and then the echo probe was removed. A partial upper sternotomy was constructed and the mitral valve exposed with a combined superior and transseptal approach to the left atrium. The mitral valve was replaced with a 25 mm Carpentier-Edwards Perimount valve (Edwards Lifesciences, LLC, Newport Beach, Calif). The Cobra RF System (Boston Scientific, Boston,
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S. L. Gaynor, Y. Ishii, M. D. Diodato, S. M. Prasad, K. M. Barnett, N. R. Damiano, G. D. Byrd, S. A. Wickline, R. B. Schuessler, and R. J. Damiano Jr Successful Performance of Cox-Maze Procedure on Beating Heart Using Bipolar Radiofrequency Ablation: A Feasibility Study in Animals Ann. Thorac. Surg., November 1, 2004; 78(5): 1671 - 1677. [Abstract] [Full Text] [PDF]
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S. L. Gaynor, M. D. Diodato, S. M. Prasad, Y. Ishii, R. B. Schuessler, M. S. Bailey, N. R. Damiano, J. B. Bloch, M. R. Moon, and R. J. Damiano Jr A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation J. Thorac. Cardiovasc. Surg., October 1, 2004; 128(4): 535 - 542. [Abstract] [Full Text] [PDF]
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C. Pappone, H. Oral, V. Santinelli, G. Vicedomini, C. C. Lang, F. Manguso, L. Torracca, S. Benussi, O. Alfieri, R. Hong, et al. Atrio-Esophageal Fistula as a Complication of Percutaneous Transcatheter Ablation of Atrial Fibrillation Circulation, June 8, 2004; 109(22): 2724 - 2726. [Abstract] [Full Text] [PDF]
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K. Khargi, A. Laczkovics, K. Muller, and T. Deneke A possible surgical technique to avoid esophageal and circumflex artery injuries using radiofrequency ablation to treat atrial fibrillation Interact CardioVasc Thorac Surg, June 1, 2004; 3(2): 352 - 355. [Abstract] [Full Text] [PDF]
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N. Doll, F. W. Mohr, and M. A. Borger Reply to the Editor J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2120 - 2120. [Full Text] [PDF]
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N. Doll, B. B. Kiaii, A. M. Fabricius, J. Bucerius, P. Kornherr, R. Krakor, J. F. Gummert, T. Walther, and F. W. Mohr Intraoperative left atrial ablation (for atrial fibrillation) using a new argon cryocatheter: early clinical experience Ann. Thorac. Surg., November 1, 2003; 76(5): 1711 - 1715. [Abstract] [Full Text] [PDF]
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J. Raman, S. Ishikawa, M. M. Storer, and J. M. Power Surgical radiofrequency ablation of both atria for atrial fibrillation: results of a multicenter trial J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1357 - 1365. [Abstract] [Full Text] [PDF]
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A. M. Gillinov, P. M. McCarthy, G. Pettersson, B. W. Lytle, and T. W. Rice Esophageal perforation during left atrial radiofrequency ablation: is the risk too high? J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1661 - 1662. [Full Text] [PDF]
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S. M. Prasad, H. S. Maniar, M. D. Diodato, R. B. Schuessler, and R. J. Damiano Jr Physiological consequences of bipolar radiofrequency energy on the atria and pulmonary veins: a chronic animal study Ann. Thorac. Surg., September 1, 2003; 76(3): 836 - 842. [Abstract] [Full Text] [PDF]
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K. Khargi, T. Deneke, B. Lemke, and A. Laczkovics Irrigated radiofrequency ablation is a safe and effective technique to treat chronic atrial fibrillation Interact CardioVasc Thorac Surg, September 1, 2003; 2(3): 241 - 245. [Abstract] [Full Text] [PDF]
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B. Akpinar, M. Guden, E. Sagbas, I. Sanisoglu, U. Ozbek, B. Caynak, and O. Bayindir Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results Eur J Cardiothorac Surg, August 1, 2003; 24(2): 223 - 230. [Abstract] [Full Text] [PDF]
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B. Sonmez, E. Demirsoy, N. Yagan, M. Unal, H. Arbatli, D. Sener, T. Baran, and F. Ilkova A fatal complication due to radiofrequency ablation for atrial fibrillation: atrio-esophageal fistula Ann. Thorac. Surg., July 1, 2003; 76(1): 281 - 283. [Abstract] [Full Text] [PDF]
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S. Benussi, S. Nascimbene, S. Calvi, and O. Alfieri A tailored anatomical approach to prevent complications during left atrial ablation Ann. Thorac. Surg., June 1, 2003; 75(6): 1979 - 1981. [Abstract] [Full Text] [PDF]
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N. Doll, M. A. Borger, A. Fabricius, S. Stephan, J. Gummert, F. W. Mohr, J. Hauss, H. Kottkamp, and G. Hindricks Esophageal perforation during left atrial radiofrequency ablation: Is the risk too high? J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 836 - 842. [Abstract] [Full Text] [PDF]
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R. J. Damiano Jr Alternative energy sources for atrial ablation: judging the new technology Ann. Thorac. Surg., February 1, 2003; 75(2): 329 - 330. [Full Text] [PDF]
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A. M. Gillinov, E. H. Blackstone, and P. M. McCarthy Atrial fibrillation: current surgical options and their assessment Ann. Thorac. Surg., December 1, 2002; 74(6): 2210 - 2217. [Abstract] [Full Text] [PDF]
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A. M. Patwardhan, V. S. Lad, and V. Pai Esophageal injury during radiofrequency ablation for atrial fibrillation: Inherent safety of radiofrequency bipolar coagulation J. Thorac. Cardiovasc. Surg., September 1, 2002; 124(3): 642 - 643. [Full Text] [PDF]
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F. Gaita and R. Riccardi Lone atrial fibrillation ablation: Transcatheter or minimally invasive surgical approaches? J. Am. Coll. Cardiol., August 7, 2002; 40(3): 481 - 483. [Full Text] [PDF]
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