Totally thoracoscopic left atrial Maze: standardized, effective and safe

Autor: Mohamed Bentala, Guillaume S.C. Geuzebroek, Bart P. van Putte, Jeroen Schaap, Sander G. Molhoek, Johannes C. Kelder
Rok vydání: 2015
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Radiofrequency ablation
medicine.medical_treatment
Catheter ablation
030204 cardiovascular system & hematology
law.invention
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
law
Internal medicine
Atrial Fibrillation
E-Comment
Thoracoscopy
medicine
Humans
Sinus rhythm
Atrial tachycardia
Aged
Retrospective Studies
medicine.diagnostic_test
Atrium (architecture)
Thoracic Surgery
Video-Assisted
business.industry
Atrial fibrillation
Middle Aged
Cardiac Ablation
medicine.disease
Surgery
Treatment Outcome
Atrial Flutter
030228 respiratory system
Pulmonary Veins
Catheter Ablation
Cardiology
Female
Clinical Competence
ORIGINAL ARTICLES
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Anti-Arrhythmia Agents
Learning Curve
Zdroj: Interactive CardioVascular and Thoracic Surgery. 22:259-264
ISSN: 1569-9285
1569-9293
DOI: 10.1093/icvts/ivv358
Popis: OBJECTIVES: The totally thoracoscopic left atrial Maze (TT-Maze) is a relatively new surgical solution for the treatment of atrial fibrillation (AF). The procedure consists of a complete left atrial Maze, which is performed by video-assisted thoracoscopy with the use of radiofrequency ablation. We describe our rhythm results as well as our learning curve experience of the TT-Maze. METHODS: To evaluate the learning curve, all consecutive patients who underwent a TT-Maze and were operated by one surgeon (Bart P. Van Putte) were included in the study. The endpoint of surgery was sinus rhythm with a bidirectional block of the box and pulmonary veins. RESULTS: A total of 83 patients were included. Fifty percent of the patients had paroxysmal AF. The mean indexed left atrial volume was 44 ± 15 ml/m 2 and 38% of the patients had a previous catheter ablation for AF. During a mean follow-up of 10.9 ± 4.9 months, there were no major events. At latest follow-up, 82% of the patients did not have a single registration of AF or other atrial tachyarrhythmias longer than 30 s. Patients without AF were also free from anti-arrhythmic drugs in 90% of the cases, free from coumadins or direct oral anticoagulants in 63% of the cases and free from both in 58% of the cases. CONCLUSIONS: After almost 1-year follow-up, the TT-Maze is proved to be a successful, safe and reproducible strategy for the treatment of all types of AF including patients with enlarged left atria and previously failed catheter ablation.
Databáze: OpenAIRE
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