Tareq Aleinati
Chest Diseases Hospital, Kuwait
Title: Concomitant cryoablation for atrial fibrillation through right minithoracotomy: Early results
Biography
Biography: Tareq Aleinati
Abstract
AF is the most frequently encountered tachyarrthymia in cardiac surgery patients. Maze IV and its LA lesion set are both associated with the highest success rate of treatment of AF. Recently we introduced minimally invasive cryoablation Maze in our institution. Our study objective is to evaluate feasibility, safety, and early results of concomitant AF treatment with argon based cryoablation in patients undergoing valvular procedures through right minithoracotomy.
Methods and results
Between October 2016 and January 2017, data were retrospectively collected of all patients who underwent cryoablation Maze combined with valve surgeries through right minithoracotomy approach. Argon based cryoablation devices were used in all cases. Seven patients were identified. Five of those underwent one-valve surgery, one had two-valve surgery with ASD closure, and one had three-valve surgery, all with cryoablation Maze. Four (58%) were females, average age was 56 years, 4(58%) had rheumatic valvular disease while 3(42%) had degenerative MR. LVEF 51±9.1% and left atrial size 69.4±20 mm. All patients had permanent AF. CPB and cross clamp times were 256±60 and 184±52 minutes respectively. There were no mortality, MACE or stroke. Five patients (71%) were in normal sinus rhythm at 8 month follow up.
Conclusion
Our initial experience using Argon based cryoablation for concomitant treatment of AF through right minithoracotomy seems to be feasible and safe. Our early success rate (71%) in treating AF through this approach is promising. We also demonstrated that such approach seems to be feasible and successful in complex multiple valve procedures associated with permanent AF and large atria. A bigger study group and more than one year follow up results are needed to support our initial conclusion.