Other Hybrid Approaches Are Not Closed
Chest, They Are Invasive and Complex
While stand alone catheter approaches primarily target paroxysmal patients, surgical approaches have had some success in addressing the chronic population; but until the Convergent Procedure, the approaches have been very invasive. Other “hybrid” (surgical and EP) and “Mini Maze” stand alone approaches require chest incisions, ports, lung deflation, and heart tissue dissection; and they still do not consistently isolate the posterior of the left atrium which is considered critical to long term success.
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The table below illustrates the differences of the Convergent Procedure with SUBTLE™ access over Hybrid Approaches that utilize bi-lateral thoracotomies with clamps and pens. The Hybrid approach will not be widely accepted, we believe, as cardiologists will not refer patients for such an invasive, complex procedure with significant recovery issues.
Comparison of SUBTLE™ Access to Bi-Lateral Thoracotomies |
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| Characteristic |  |
Bi-lateral Thoracotomies |
| Avoids chest incisions | Y | N |
| Provides direct visualization of device placement and all lesions | Y | N |
| Creates lesions along posterior surface of heart | Y | N |
| Allows patient to be in supine position, no rotation of patient during procedure | Y | N |
| Avoids lung deflation, especially sequential single lung ventilation | Y | N |
| Avoids dissections of PVs, transverse sinus and oblique sinus | Y | N |
| Maintains integrity of pericardium to prevent adhesions | Y | N |
| Complements catheter ablation, doesn’t replicate ablation lesions | Y | N |
| Approximate epicardial skin-skin procedure time <2 hours | Y | N |
| Avoids damage to intercostal nerves associated with severe acute and chronic pain | Y | N |
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The Convergent Procedure with SUBTLE™ Access is the only truly
minimally invasive multi-disciplinary approach.
AF Treatment
“Techniques such as the Convergent Procedure are the future of atrial fibrillation treatment as it leaves the thoracic cavity and lungs undisturbed, while enabling the cardiac surgeon to have visibility and access to
the heart. This will be an important advantage in the minds of cardiologists and patients, as the approach is thought of simply as a ‘procedure’ rather than surgery.”
Professor Gerhard
Wimmer-Greinecker,
Bad Bevensen, Germany