A cryoablation procedure was performed on (b)(6) 2011.
Pulmonary veins were 14-19mm, physician used 23mm balloon catheter.
Procedure involved a single transeptal puncture as the physician used the achieve mapping catheter.
Left superior pulmonary vein ablated using cryoballoon with 4 freezes of 4 minutes in duration with a lowest temperature of -75 degrees c.
Left inferior pulmonary vein treated with 5 freezes of 4 minutes with the cryoballoon with a lowest temperature of -69 degrees c.
During treatment of the right sided pulmonary veins with the cryoballoon, the physician observed that the diaphragm was sluggish and the temperatures were at -74 degrees c.
Ablation was stopped and veins were found to be isolated so the physician stopped the procedure and all was fine.
Physician finished with a flutter line using rf.
The patient seemed well and went home the next day.
At his one month check, the patient reported a cough.
Chest x-ray obtained with no issues noted and patient checked out fine and went home.
Two weeks later (approximately 6 weeks post procedure), the patient was admitted to hospital with symptoms of tia/stroke and 2 weeks of fever and weight loss.
Patient began to have seizures.
Ct/tee showed vegetation near the antrum to the lspv and patient was taken to the o.
For surgical removal.
During procedure, surgeon noted what he thought was a communication from the la but did not uncover the source.
Vegetation was removed and the esophagus was noted as being directly behind this site.
Patient never woke from the effects of the stroke, the family disconnected care and he passed away.
The pathologist report was finalized and medtronic was notified of the pathology report contents on january 13, 2012.
Although the pathologist didn't find any gross evidence of ae fistula, the brain pathology showed vegetative fibers, thus inferring indirect evidence of esophageal fistula.