Document Detail


Video-assisted minimally invasive surgery for lone atrial fibrillation: a clinical report of 81 cases.
MedLine Citation:
PMID:  19660413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We sought to evaluate the feasibility and efficacy of a new type of video-assisted minimally invasive surgery for patients with atrial fibrillation. METHODS: Between December 2006 and February 2008, 81 patients with lone atrial fibrillation (49 with paroxysmal, 17 with persistent, and 15 with long-standing persistent atrial fibrillation) underwent this therapy with a bipolar radiofrequency ablation system. The main surgical procedures included bilateral pulmonary vein antrum isolation, obliteration of the left atrial appendage, division of the ligament of Marshall, and intraoperative electrophysiologic testing. RESULTS: The mean operation duration was 2.5 hours. One (1.2%) case was confirmed of left atrial appendage thrombus during the procedure. One (1.2%) patient was converted to sternotomy during the operation. Reintubation occurred in 1 (1.2%) patient, and acute heart failure occurred in 1 (1.2%) patient. One (1.2%) patient died of cerebral infarction 1 month after the operation. Follow-up was done between 3 and 19 months (mean, 12.7 +/- 3.9 months) after the operation. At discharge, 72.5% (58/81) of all patients were in sinus rhythm (paroxysmal atrial fibrillation, 83.7%; persistent atrial fibrillation, 64.7%; and long-standing persistent atrial fibrillation, 40.0%). At 3 months, overall 78.5% (62/79) were in sinus rhythm (paroxysmal atrial fibrillation, 85.7%; persistent atrial fibrillation, 82.4%; and long-standing persistent atrial fibrillation, 46.2%). At 6 months, overall 78.5% (62/79) were in sinus rhythm (paroxysmal atrial fibrillation, 85.7%; persistent atrial fibrillation, 70.6%; and long-standing persistent atrial fibrillation, 61.5%). At 12 months, overall 79.6% (39/49) were in sinus rhythm (paroxysmal atrial fibrillation, 80.0%; persistent atrial fibrillation, 75.0%; and long-standing persistent atrial fibrillation, 66.7%). At 18 months, 88.9% (8/9) of the paroxysmal group were in sinus rhythm. CONCLUSIONS: This minimally invasive technique proves to be safe and less traumatic and presents optimistic early outcomes for patients with paroxysmal and persistent atrial fibrillation. It might find wider application if more ablation lesions could be enrolled for long-standing persistent atrial fibrillation.
Authors:
Yong-qiang Cui; Yan Li; Feng Gao; Chun-lei Xu; Jie Han; Wen Zeng; Ya-ping Zeng; Emin Gurbanov; Xu Meng
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Publication Detail:
Type:  Journal Article     Date:  2009-07-25
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  139     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  326-32     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Atrial fibrillation Center, Anzhen Hospital, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Atrial Appendage / surgery
Atrial Fibrillation / epidemiology,  surgery*
Cardiac Surgical Procedures / methods
Catheter Ablation / methods*
Comorbidity
Electrophysiologic Techniques, Cardiac
Female
Humans
Male
Middle Aged
Retrospective Studies
Surgical Procedures, Minimally Invasive

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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