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Minimally invasive surgical therapies for atrial fibrillation.

Nakamura Y, Kiaii B, Chu MW - ISRN Cardiol (2012)

Bottom Line: Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death.Minimally invasive surgical ablation is an emerging field that aims for the superior results of the traditional Cox-Maze procedure through a less invasive operation with lower morbidity, quicker recovery, and improved patient satisfaction.These novel techniques utilize endoscopic or minithoracotomy approaches with various energy sources to achieve electrical isolation of the pulmonary veins in addition to other ablation lines.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiac Surgery, Department of Surgery, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.

ABSTRACT
Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death. There have been major advances in the management of atrial fibrillation including pharmacologic therapies, antithrombotic therapies, and ablation techniques. Surgery for atrial fibrillation, including both concomitant and stand-alone interventions, is an effective therapy to restore sinus rhythm. Minimally invasive surgical ablation is an emerging field that aims for the superior results of the traditional Cox-Maze procedure through a less invasive operation with lower morbidity, quicker recovery, and improved patient satisfaction. These novel techniques utilize endoscopic or minithoracotomy approaches with various energy sources to achieve electrical isolation of the pulmonary veins in addition to other ablation lines. We review advancements in minimally invasive techniques for atrial fibrillation surgery, including management of the left atrial appendage.

No MeSH data available.


Related in: MedlinePlus

(a) intraoperative view of minimally invasive concomitant mitral valve repair and Cryomaze procedure. The argon-based flexible, linear ablation probe is applied through a 3 cm right minithoracotomy. (b) intraoperative view of minimally invasive, videoscopic Cryomaze setup.
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fig2: (a) intraoperative view of minimally invasive concomitant mitral valve repair and Cryomaze procedure. The argon-based flexible, linear ablation probe is applied through a 3 cm right minithoracotomy. (b) intraoperative view of minimally invasive, videoscopic Cryomaze setup.

Mentions: The Cryomaze can be performed endoscopically, robotically or through a 3-4 cm right minithoracotomy using cardiopulmonary bypass with femoro-femoral cannulations and right jugular venous cannulation (Figures 2(a) and 2(b)) [35, 37]. The CryoCath ablation system (Medtronic Inc., MN, USA) uses argon to cool tissue to as low as −160°C. The system is well suited to a minimally invasive technique because it is a flexible, linear probe available in lengths of 6–10 cm. The minimally invasive Cryomaze procedure has also demonstrated excellent results in the lone AF population [37]. A total of 41 patients with lone AF underwent a minimally invasive, biatrial Cryomaze with no deaths or strokes. At discharge and 6 weeks postoperatively, 36 (87.8%) and 37 (90.2%) patients were in sinus rhythm, respectively. At later followup, sinus rhythm was present in 93% (38/41) at 3 months, 87% (34/39) at 6 months, and 87% (20/23) at one year [37].


Minimally invasive surgical therapies for atrial fibrillation.

Nakamura Y, Kiaii B, Chu MW - ISRN Cardiol (2012)

(a) intraoperative view of minimally invasive concomitant mitral valve repair and Cryomaze procedure. The argon-based flexible, linear ablation probe is applied through a 3 cm right minithoracotomy. (b) intraoperative view of minimally invasive, videoscopic Cryomaze setup.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3362139&req=5

fig2: (a) intraoperative view of minimally invasive concomitant mitral valve repair and Cryomaze procedure. The argon-based flexible, linear ablation probe is applied through a 3 cm right minithoracotomy. (b) intraoperative view of minimally invasive, videoscopic Cryomaze setup.
Mentions: The Cryomaze can be performed endoscopically, robotically or through a 3-4 cm right minithoracotomy using cardiopulmonary bypass with femoro-femoral cannulations and right jugular venous cannulation (Figures 2(a) and 2(b)) [35, 37]. The CryoCath ablation system (Medtronic Inc., MN, USA) uses argon to cool tissue to as low as −160°C. The system is well suited to a minimally invasive technique because it is a flexible, linear probe available in lengths of 6–10 cm. The minimally invasive Cryomaze procedure has also demonstrated excellent results in the lone AF population [37]. A total of 41 patients with lone AF underwent a minimally invasive, biatrial Cryomaze with no deaths or strokes. At discharge and 6 weeks postoperatively, 36 (87.8%) and 37 (90.2%) patients were in sinus rhythm, respectively. At later followup, sinus rhythm was present in 93% (38/41) at 3 months, 87% (34/39) at 6 months, and 87% (20/23) at one year [37].

Bottom Line: Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death.Minimally invasive surgical ablation is an emerging field that aims for the superior results of the traditional Cox-Maze procedure through a less invasive operation with lower morbidity, quicker recovery, and improved patient satisfaction.These novel techniques utilize endoscopic or minithoracotomy approaches with various energy sources to achieve electrical isolation of the pulmonary veins in addition to other ablation lines.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiac Surgery, Department of Surgery, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.

ABSTRACT
Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death. There have been major advances in the management of atrial fibrillation including pharmacologic therapies, antithrombotic therapies, and ablation techniques. Surgery for atrial fibrillation, including both concomitant and stand-alone interventions, is an effective therapy to restore sinus rhythm. Minimally invasive surgical ablation is an emerging field that aims for the superior results of the traditional Cox-Maze procedure through a less invasive operation with lower morbidity, quicker recovery, and improved patient satisfaction. These novel techniques utilize endoscopic or minithoracotomy approaches with various energy sources to achieve electrical isolation of the pulmonary veins in addition to other ablation lines. We review advancements in minimally invasive techniques for atrial fibrillation surgery, including management of the left atrial appendage.

No MeSH data available.


Related in: MedlinePlus