Cryosurgical ablation of XXXX without extracorporeal circulation.

@entity1 @entity713 @entity8942 @entity591 @entity4710
A closed technique, using thoracotomy without cardiopulmonary bypass and atriotomy, for cryosurgical ablation of the atrioventricular node-His bundle junction is described. The technique was used in 34 @entity1 selected from among 136 @entity1 with disabling @entity4710 refractory to drug therapy in whom @entity713 was produced. After thoracotomy, four methods can be used to determine the site of cryoinstrument application: palpation of the internal anatomic landmarks, a "mechanical test," use of a cryoprobe, or recording of the His bundle electrogram. The cryoprocedure lasts 160 to 180 seconds at temperatures of -60 degrees to -80 degrees C and is repeated once or twice. Complete @entity713 was induced in 29 of the 34 @entity1 . @entity8942 was terminated in 31. There were no operative deaths. The frequency of surgical complications was nearly three times lower than in the group of 77 @entity1 subjected to open cryodestruction of the @entity713 , and the length of hospital stay after the operation was an average of 4.7 days shorter. The follow-up for up to 6.5 years (mean 34 months) failed to show postoperative paroxysmal @entity591 or @entity591 in 31 @entity1 . In my opinion, this rather safe method for ablation of the @entity713 could be more widely used, especially if there are contraindications for extracorporeal circulation or if transvenous catheter ablation has failed.
