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J Thorac Cardiovasc Surg 2009;137:1573-1574
© 2009 The American Association for Thoracic Surgery

Letter to the Editor

Clamping the mitral and tricuspid annuli with bipolar devices

Stefano Benussi, MD, PhD

Division of Cardiac Surgery, S Raffaele University Hospital, Milan, Italy

Domenico Corradi, MD

Pathology Section, Department of Pathology and Laboratory Medicine, University of Parma, Parma, Italy

Ottavio Alfieri, MD

Division of Cardiac Surgery, S Raffaele University Hospital, Milan, Italy

The first 20% of the full text of this article appears below.

To the Editor:

Castella and colleagues' article1Go reports evidence collected by application of a bipolar radiofrequency clamp on 8 explanted hearts and postmortem analysis of 1 patient who died hours after surgery. The authors unveil 2 main findings: They state it is not possible to clamp across the mitral annulus because of the increased thickness of the atrioventricular (AV) groove, related to the superimposition of the ventricular mass and fat tissue. They also claim that, although feasible, clamping up to the tricuspid annulus would always include the main right coronary artery. The authors conclude that both ablations are unfeasible with bipolar radiofrequency in clinical practice. The only viable options are to cut and sew up to the annulus, which is impractical, or to use an additional unipolar . . . [Full Text of this Article]






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