Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation

Wolf, Randall K.; Schneeberger, Eric W.; Osterday, Robert M.; Miller, David; Merrill, Walter H.; Flege, John B.; Gillinov, A. Marc

doi:10.1016/j.jtcvs.2005.03.041

Cited by 353 publications

(259 citation statements)

References 33 publications

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“…LECZENIE CHIRURGICZNE MIGOTANIA PRZEDSIONKÓW Minimalnie inwazyjną ablację chirurgiczną od strony nasierdzia jako "oddzielne" leczenie AF opisano dekadę temu [1035]. Od tamtego czasu zabieg ten wyewoluował w procedurę całkowicie torakoskopową [1036], a zakres wywoływanych uszkodzeń rozszerzono do pełnego labiryntu w obrębie lewego przedsionka [822].…”

Section: Torakoskopowe "Oddzielne"unclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,379

4,206

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Section: Torakoskopowe "Oddzielne"unclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,379

4,206

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“…The minimally invasive surgical approach using video-assisted PV ablation and exclusion of the LAA was first described in 2005. 1353 A bipolar RF clamp was used for PVI on the beating heart in 27 patients, among whom 18 had PAF. Among the 23 patients followed for more than 3 months, 21 (91%) were free of AF and 65% were off all AADs.…”

Section: Stand-alone Surgical Ablation Of Afmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,760

1,468

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“…Pulmonary vein isolation and excision of the left atrial appendage can be performed with the use of a minimally invasive "keyhole approach" or thoracoscopically; neither approach requires cardiopulmonary bypass. 43,44 These minimally invasive procedures enable wide, circumferential pulmonary vein isolation, either with a single "box" lesion or separate oval-shaped ablations on the right and left. Procedure times are generally 2 to 4 hours, and median length of hospital stay is 3 days.…”

Section: Current Indications and Strategies For Surgical Af Ablationmentioning

confidence: 99%

Advances in Surgical Treatment of Atrial Fibrillation

Gillinov

2007

Stroke

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Abstract-Atrial fibrillation (AF) is the most common sustained arrhythmia. It is associated with increased risks of death and stroke; most strokes in AF patients are thought to arise from thrombi in the left atrial appendage. Surgical ablation of AF includes excision of the left atrial appendage and is an effective means of treating this arrhythmia, with the classic Maze procedure curing AF in Ͼ90% of patients and virtually eliminating the risk of late stroke. A complex but safe operation, the Maze procedure has been applied by relatively few surgeons. Americans; this number is expected to increase to Ͼ5.6 million by 2050. 1 The prevalence of AF increases with increasing patient age, and recent data from the Framingham Heart Study suggest that the lifetime risks for development of AF are 1 in 4 for men and women aged Ն40 years. 2 This epidemic has a growing impact on the healthcare system and a multibillion dollar cost. The clinical consequences of AF are well documented. AF is associated with reduced life expectancy and increases the risk of stroke 5-fold, accounting for Ϸ15% of all strokes nationally. 3-8 These AF-related strokes are a major challenge and a focus of several clinical trials investigating strategies for primary and secondary prevention. 4 Currently, antithrombotic therapy is the mainstay for stroke prevention in AF patients.Although there is currently some consensus concerning pharmacological strategies for stroke prevention in AF patients, choice of therapy for the heart rhythm is controversial and evolving. 9,10 Available antiarrhythmic therapies inconsistently restore sinus rhythm and are associated with complications. In fact, the risks associated with antiarrhythmic drug therapy may counterbalance the potential benefit of restoration of sinus rhythm. 9,10 These observations, coupled with increased understanding of the pathogenesis of AF, have resulted in the development of interventional strategies to restore sinus rhythm. Both catheter-based and surgical approaches have demonstrated effectiveness in this regard. Developed by Dr James Cox, the classic Maze procedure is the predicate operation for ablation of AF; long-term data suggest that the Maze procedure eliminates AF in Ͼ90% of patients. 11-14 Despite these unmatched results, the complexity and time associated with the Maze procedure have prevented widespread application by surgeons.Recently, however, there has been increased interest in direct surgical ablation of AF, fueled by technological advances and demonstration that the pulmonary veins and left atrium are the drivers of AF in most patients. 15 New ablation technologies enable surgeons to perform pulmonary vein isolation, create strategically placed, linear left atrial lesions, and excise the left atrial appendage rapidly and safely. 16 -23 Alternate energy sources used to create lines of conduction block and replace surgical incisions of the Maze procedure include radiofrequency, microwave, ultrasound, cryothermy, and laser. 16 -25 Applied primarily in patients with valvular...

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Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation

Abstract: Bilateral video-assisted thoracoscopic pulmonary vein isolation with excision of the left atrial appendage is feasible and safe and offers a promising, new, minimally invasive, beating-heart approach for curative surgical treatment of atrial fibrillation.

Cited by 353 publications

References 33 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Advances in Surgical Treatment of Atrial Fibrillation

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