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Surgical Ablation of Atrial Fibrillation and Left Atrial Appendage Occlusion by a Totally Videothoracoscopic Approach - New Paradigm?

2021Journal article Open access
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dc.contributor.authorRodrigues, C
dc.contributor.authorSilva, M
dc.contributor.authorCerejo, R
dc.contributor.authorPortugal, G
dc.contributor.authorCunha, PS
dc.contributor.authorRodrigues, R
dc.contributor.authorOliveira, MM
dc.contributor.authorFragata, J
dc.date.accessioned2022-04-06T14:36:34Z
dc.date.available2022-04-06T14:36:34Z
dc.date.issued2021
dc.description.abstractIntroduction: Atrial fibrillation (AF) contributes to increased morbidity and mortality. Pharmacological and percutaneous catheter therapies are unsatisfactory, with potential serious adverse effects. Cox-Maze III/IV surgery, with higher rates of success, has not been widely adopted because of the associated complexity of the procedure. Methods: We performed a retrospective analysis of the first patients submitted to surgical ablation of AF with occlusion of the left atrial appendage with a totally videothoracoscopic (VATS) approach in our institution. We describe the surgical technique and our results, including duration of surgery, hospital stay, complications and maintenance of sinus rhythm after surgery, at 6, 12 and 18 months of follow-up. Results: We studied 15 patients (ages ranging from 39 to 75 years old; 54,5% female gender). Mean time since the diagnosis of AF was 5,75 years. All had been submitted to prior catheter ablation (mean of 2 attempts). Mean diameter and volume of the left atrium was 42 mm (M-mode) and 70 ml (43 ml/m2), respectively. Mean duration of surgery was 2 hours and 22 minutes. In one patient we had to convert the surgery to median sternotomy. Mean hospital stay was 4,8 days. Mean time of follow-up was 12 months. During follow-up, 91%, 90% and 80% of the patients were in sinus rhythm at 6, 12 and 18 months, respectively. Conclusion: This surgical approach represents a real benefit for those patients with multiple attempts of catheter ablation without success. However, a larger sample of patients with a longer period of follow-up is necessary for further conclusions.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPort J Card Thorac Vasc Surg. 2021 Nov 7;28(3):21-24.pt_PT
dc.identifier.doi10.48729/pjctvs.190.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4039
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Cirurgia Cardio-Torácica e Vascularpt_PT
dc.subjectHSM CCTpt_PT
dc.subjectHSM CARpt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectAtrial Appendage* / surgerypt_PT
dc.subjectAtrial Fibrillation* / surgerypt_PT
dc.subjectCatheter Ablation* / adverse effectspt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectTreatment Outcomept_PT
dc.titleSurgical Ablation of Atrial Fibrillation and Left Atrial Appendage Occlusion by a Totally Videothoracoscopic Approach - New Paradigm?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage24pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage21pt_PT
oaire.citation.titlePortuguese Journal of Cardiac Thoracic and Vascular Surgerypt_PT
oaire.citation.volume28pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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