Right atrium positioning for exposure of right pulmonary veins during off-pump atrial fibrillation ablation
| Autor: | Jakub Mróz, Grzegorz Suwalski, Kamil Kaczejko, Andrzej Cwetsch, Robert W. Emery, Andrzej Skrobowski, Leszek Gryszko |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Suction (medicine) medicine.medical_specialty medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Left atrial appendage occlusion Patient Positioning Pulmonary vein 03 medical and health sciences 0302 clinical medicine Blunt dissection Heart Conduction System Internal medicine Atrial Fibrillation medicine Humans Heart Atria Aged business.industry Atrial fibrillation Ablation medicine.disease Treatment Outcome 030228 respiratory system Pulmonary Veins Catheter Ablation cardiovascular system Cardiology Female Surgery Electrical conduction system of the heart Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 24:823-827 |
| ISSN: | 1569-9285 1569-9293 |
| DOI: | 10.1093/icvts/ivx026 |
| Popis: | OBJECTIVES Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of the ablation procedure. This study evaluates the safety and feasibility of right atrial positioning using a suction-based cardiac positioner as opposed to compressive manoeuvres for exposure during off-pump surgical ablation for AF. METHODS Thirty-four consecutive patients underwent pulmonary vein isolation, ganglionated plexi ablation and left atrial appendage occlusion during off-pump coronary artery bypass grafting. Right atrial suction positioning was used to visualize right pulmonary veins. Safety and feasibility end points were analysed intraoperatively and in the early postoperative course. RESULTS In all patients, right atrial positioning created optimal conditions to complete transverse and oblique sinus blunt dissection, correct placement of a bipolar ablation probe, detection and ablation of ganglionated plexi and conduction block assessment. In all patients, this entire right-sided ablation procedure was completed with a single exposure manoeuvre. Feasibility end points were achieved in all study patients. CONCLUSIONS This report documents the safety and feasibility of right atrial exposure using a suction-based cardiac positioner to complete ablation for AF concomitant with off-pump coronary revascularization. This technique may be widely adopted to create stable haemodynamic conditions and optimal visualization of the right pulmonary veins. |
| Databáze: | OpenAIRE |
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