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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

Operative setup for minimally invasive biatrial Cryomaze procedure with concomitant mitral valve repair. (a): intraoperative patient positioning, (b): 2 months postoperative result.
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fig3: Operative setup for minimally invasive biatrial Cryomaze procedure with concomitant mitral valve repair. (a): intraoperative patient positioning, (b): 2 months postoperative result.

Mentions: The biatrial Cryomaze procedure is our preferred method of surgical treatment for atrial fibrillation. We treat patients with symptomatic paroxysmal or permanent AF with a duration <10 years, left atrial size <6.5 cm, who have strong motivations to be anticoagulation free. Most patients that we treat also have concomitant mitral valve disease that requires surgical intervention. We employ videoscopic assistance to perform the operation through a 3-4 cm right minithoracotomy with peripheral cannulation (Figures 2 and 3). Following the ablation, prior to the mitral valve repair, we generally perform a left atrial appendectomy by invaginating, excising, and oversewing the stump of the left atrial appendage from within the left atrium. We have experienced good success rates with freedom from recurrent atrial fibrillation >90% and 80% in patients with paroxysmal and persistent AF, respectively.


Minimally invasive surgical therapies for atrial fibrillation.

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

Operative setup for minimally invasive biatrial Cryomaze procedure with concomitant mitral valve repair. (a): intraoperative patient positioning, (b): 2 months postoperative result.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3362139&req=5

fig3: Operative setup for minimally invasive biatrial Cryomaze procedure with concomitant mitral valve repair. (a): intraoperative patient positioning, (b): 2 months postoperative result.
Mentions: The biatrial Cryomaze procedure is our preferred method of surgical treatment for atrial fibrillation. We treat patients with symptomatic paroxysmal or permanent AF with a duration <10 years, left atrial size <6.5 cm, who have strong motivations to be anticoagulation free. Most patients that we treat also have concomitant mitral valve disease that requires surgical intervention. We employ videoscopic assistance to perform the operation through a 3-4 cm right minithoracotomy with peripheral cannulation (Figures 2 and 3). Following the ablation, prior to the mitral valve repair, we generally perform a left atrial appendectomy by invaginating, excising, and oversewing the stump of the left atrial appendage from within the left atrium. We have experienced good success rates with freedom from recurrent atrial fibrillation >90% and 80% in patients with paroxysmal and persistent AF, respectively.

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