Outcomes of Surgical Atrial Fibrillation Ablation: The Port Access Approach vs. Median Sternotomy.
- Author:
Won Kyoun PARK
1
;
Jae Won LEE
;
Joon Bum KIM
;
Sung Ho JUNG
;
Suk Jung CHOO
;
Cheol Hyun CHUNG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. jwlee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Arrhythmia surgery;
Minimally invasive surgery;
Mitral valve;
Atrial fibrillation
- MeSH:
Atrial Fibrillation;
Cardiopulmonary Bypass;
Disease-Free Survival;
Freedom;
Hemorrhage;
Humans;
Mitral Valve;
Propensity Score;
Reoperation;
Sternotomy;
Thoracic Surgery
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2012;45(1):11-18
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases. MATERIALS AND METHODS: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups' baseline characteristics, a propensity score analysis was performed. RESULTS: After adjustment, there were no significant differences in the two groups' baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group (176.0+/-49.5 minutes) than the sternotomy group (150.0+/-51.9 minutes). There were no significant differences (p=0.31) in the two groups' rate of reoperation for bleeding (MICS=6 vs. sternotomy= 2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were 87.4+/-8.1% in the MICS group and 89.6+/-5.8% in the sternotomy group (p=0.92). Freedom from late AF at 2 years was 86.8+/-6.2% in the MICS group and 85.0+/-6.9% in the sternotomy group (p=0.86). CONCLUSION: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.
