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Thoracoscopy atrial fibrillation

Manuel Castellá, Dipak Kotecha, Charlotte van Laar, Lisette Wintgens, Yakir Castillo, Johannes Kelder, David Aragon, María Nuñez, Elena Sandoval, Aina Casellas, Lluís Mont, Wim Jan van Boven, Lucas V A Boersma, Bart P van Putte
Aims: Our objectives were to compare effectiveness and long-term prognosis after epicardial thoracoscopic atrial fibrillation (AF) ablation vs. endocardial catheter ablation, in patients with prior failed catheter ablation or high risk of failure. Methods and results: Patients were randomized to thoracoscopic or catheter ablation, consisting of pulmonary vein isolation with optional additional lines (2007-2010). Patients were reassessed in 2016/2017, and those without documented AF recurrence underwent 7-day ambulatory electrocardiography...
January 30, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
Daniel B Kim, Steven Bowers, Mathew Thomas
Benign esophageal strictures are typically the result of long-standing gastroesophageal reflux, and are usually treated with serial dilations and acid-suppressive therapy. Other causes of benign esophageal strictures include external beam radiation, caustic ingestions, prior surgery, and external compression from mediastinal fibrosis. We report 2 rare causes of ischemic esophageal structuring occurring after operations unrelated to the esophagus. The first is a patient who developed esophageal injury following radiofrequency ablation for atrial fibrillation...
July 2017: Seminars in Thoracic and Cardiovascular Surgery
Alan Bulava, Ales Mokracek, Jiri Hanis, Martin Eisenberger, Vojtech Kurfirst, Ladislav Dusek
BACKGROUND: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently, but their efficacy has never been systematically tested. METHODS AND RESULTS: Seventy patients (median age, 63.5 years) with persistent atrial fibrillation underwent epicardial thoracoscopic radiofrequency pulmonary vein isolation, linear ablation, Marshal ligament disruption, and exclusion of the left atrial appendage...
August 2017: Circulation. Arrhythmia and Electrophysiology
Petr Budera, Pavel Osmancik, Dalibor Herman, David Talavera, Robert Petr, Zbynek Straka
BACKGROUND: Catheter and surgical ablation of atrial fibrillation (AF) can be associated with a risk of thromboembolic events. The goal of this study was to assess optimal anticoagulation management during thoracoscopic ablation of AF. METHODS: Fifty-two patients with persistent or long-standing persistent AF underwent hybrid ablation consisting of thoracoscopic ablation followed by electrophysiologic (EP) evaluation and consecutive ablation if indicated. The thoracoscopic ablation was performed using three different anticoagulation protocols: (1) without periprocedural heparin and without occlusion of the left atrial appendage; (2) with periprocedural heparin but without left atrial appendage occlusion; and (3) with periprocedural heparin and left atrial appendage occlusion...
September 2017: Annals of Thoracic Surgery
Pejman Radkani, Devendra Joshi, Tushar Barot, Roy Williams
In spite of difficult anatomic access for tumors of mediastinum, surgical resection remains the best diagnostic and therapeutic approach. Widespread acceptance of video-assisted thoracoscopy (VATS) is restricted by the limiting nature of instruments and suboptimal visualization. Robotic assisted minimally invasive surgery seems to hold most promise in remote, narrow anatomical regions. After obtaining approval from Institutional Review Board (IRB), a retrospective review of prospectively collected database on patients that underwent Robotic VATS between 2009 and 2013 was conducted...
March 2018: Journal of Robotic Surgery
Aleš Mokráček, Vojtěch Kurfirst, Alan Bulava, Jiří Haniš
INTRODUCTION: Atrial fibrillation (AFib) is related to a high risk of stroke. The main role in etiopathogenesis is played by the left atrial appendage (LAA). As many as 95 % of thrombi in nonvalvular atrial fibrillation are located in the appendage. Prevention of stroke then consists in permanent anticoagulation which, however, has its limits and risks. An alternative method is the left atrial appendage occlusion. In our report, we would like to present a new possibility of the closure using the epicardial system AtriClip (AtriCure)...
December 0: Vnitr̆ní Lékar̆ství
Faisal F Syed MBChB, Hakan Oral Md
To overcome limitations of minimally invasive surgical ablation as a standalone procedure in eliminating atrial fibrillation (AF), hybrid approaches incorporating adjunctive endovascular catheter ablation have been proposed in recent years. The endovascular component targets residual conduction gaps and identifies additional electrophysiological targets with the goal of minimizing recurrent atrial arrhythmia. We performed a systematic review of published studies of hybrid AF ablation, analyzing 432 pooled patients (19% paroxysmal, 29% persistent, 52% long-standing persistent) treated using three different approaches: A...
December 2015: Journal of Atrial Fibrillation
Mindy Vroomen, Laurent Pison
PURPOSE: Hybrid ablation for AF is performed in a growing number of centers. Due to absence of guidelines, operative approaches and perioperative care differ per center. In this review, an overview of findings from published studies on hybrid ablations is given, and related topics are discussed (e.g., one- and two-stage approaches, lesion sets, and patient management). METHODS: A systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by the two authors...
December 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
J Liu, H M Guo, Q Gao, B Chen, B Xie, H L Huang, J Liu, C Lu, J M Chen, J Zhuang
OBJECTIVE: To summarize the clinical experience of 60 patients underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. METHODS: Sixty patients were enrolled retrospectively from March 2014 to January 2016 in Department of Cardiacvascular Surgery, Guangdong Cardiovascular Institute. They underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. There were 37 male and 23 female patients. The range of age was 15 to 78 years (the median age was 47 years)...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Alexander Romanov, Evgeny Pokushalov, Dmitry Elesin, Alexander Bogachev-Prokophiev, Dmitry Ponomarev, Denis Losik, Sevda Bayramova, Artem Strelnikov, Vitaliy Shabanov, Oleg Pidanov, Evgeny Kropotkin, Eduard Ivanickii, Alexander Karaskov, Jonathan S Steinberg
BACKGROUND: Catheter ablation is less successful for treatment of persistent atrial fibrillation (PersAF) than for paroxysmal atrial fibrillation. Some studies suggest that left atrial appendage (LAA) isolation in addition to pulmonary vein isolation (PVI) is required to maximize the benefits for PersAF after ablation. OBJECTIVE: The purpose of this study was to compare the efficacy and safety of 2 surgical ablation approaches for PersAF via video-assisted thoracoscopy: PVI + box lesion and PVI + box lesion + LAA excision...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
L Pison, R Tilz, J Jalife, M Haïssaguerre
Understanding of the pathophysiological mechanism(s) underlying atrial fibrillation (AF) is the foundation on which current ablation strategies are built. In the vast majority of patients with paroxysmal AF, the ablation procedure should target the pulmonary veins. In patients with nonparoxysmal AF, however, pulmonary vein isolation alone seems to be insufficient to prevent the arrhythmia. Several recent clinical trials have investigated the concept that rotors (re-entry based on a meandering central core from which spiral waves emanate) might be the mechanism responsible for sustaining AF...
May 2016: Journal of Internal Medicine
Pavel Osmancik, Jana Zdarska, Petr Budera, Zbynek Straka
A case of macro-reentrant tachycardia associated with a box lesion after thoracoscopis left atrial surgical atrial fibrillation (AF) ablation yet to be described. The goal was to clarify the mechanisms and electrophysiological characteristics of this type of tachycardia. A patient was admitted for an EP study following surgical thoracoscopic AF ablation (box lexion formation by right-sided Cobra thoracoscopic ablation). Thoracoscopic ablation was done as the first step of the hybrid ablation approach to the persistent AF; the second step was the EP study...
May 2015: Indian Pacing and Electrophysiology Journal
Chien-Ming Lo, Hung-I Lu, Yen-Yu Chen, Jen-Ping Chang
BACKGROUND: Radiofrequency catheter ablation for paroxysmal atrial fibrillation is well established but not drawback free. Pulmonary vein stenosis is one of the complications and usually treated with stenting with the disadvantages of high re-stenosis rate and anticoagulant dependence. CASE PRESENTATION: Herein, we present the case of a 47 year-old lady, who suffered from fever and hemoptysis due to right inferior pulmonary vein occlusion after radiofrequency catheter ablation for paroxysmal atrial fibrillation...
January 19, 2016: Journal of Cardiothoracic Surgery
Guillaume S C Geuzebroek, Mohamed Bentala, Sander G Molhoek, Johannes C Kelder, Jeroen Schaap, Bart P Van Putte
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...
March 2016: Interactive Cardiovascular and Thoracic Surgery
Phillip G Rowse, Anja C Roden, Frank M Corl, Mark S Allen, Stephen D Cassivi, Francis C Nichols, K Robert Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: The prevalence of minimally invasive thymectomy (MIT) is increasing and may have significant benefit to patients in terms of morbidity and post-operative recovery. Our aim was to review the Mayo Clinic experience of MIT. METHODS: We reviewed data from all MIT cases collected in a prospectively maintained database from January 1995 to February 2015. Data were collected regarding patient demographics, perioperative management and patient outcomes. RESULTS: A total of 510 thymectomies were performed in 20 years...
November 2015: Annals of Cardiothoracic Surgery
Sam G Aznaurov, Stephen K Ball, Christopher R Ellis
No abstract text is available yet for this article.
December 28, 2015: JACC. Cardiovascular Interventions
Hai-Tao Huang, Fei Wang, Liang Shen, Chun-Qiu Xia, Chen-Xi Lu, Chong-Jun Zhong
BACKGROUND: In China, the middle esophageal squamous cell cancer is the most common tumor type, and Mckeown esophagectomy (ME) is preferably adopted by thoracic surgeon. But, the surgical trauma of ME is great. Thoracolaparoscopic esophagectomy (TE) was developed to decrease the operative stress; however, the safety and efficacy were not defined. In this study, clinical outcomes were compared between patients who received ME and TE. METHODS: The data of 113 patients who suffered from middle-thoracic esophageal cancer during the same period were collected...
2015: World Journal of Surgical Oncology
Shungo Yukumi, Hiraku Ichiki, Junichi Funada, Hideaki Suzuki, Masamitsu Morimoto, Teppei Fujita, Naoki Izumi, Masahiro Abe
Postcardiac injury syndrome (PCIS) occurs following a pericardial or myocardial injury. On the other hand, PCIS following cardiac catheter intervention is rare and can be difficult to diagnose because of its delayed onset. A 24-year-old man underwent radiofrequency ablation (RFA) for paroxysmal atrial fibrillation and suffered from general fatigue and left-sided pleural effusion three months after the procedure. His symptoms and effusion were effectively treated within a month by administrating nonsteroidal anti-inflammatory drugs...
2015: Respiratory Medicine Case Reports
Emily A Downs, Gorav Ailawadi
Treatment of atrial fibrillation (AF) has evolved substantially, from open surgical 'cut-and-sew' procedures to catheter ablations to minimally invasive ablation with novel energy sources. Recurrences present a significant challenge, both to clinicians and to patients who seek a durable result and freedom from antiarrhythmic medications. Our centre performs a minimally invasive bilateral thoracoscopic epicardial ablation and atrial appendage exclusion, followed by a catheter-based endocardial electrophysiology study and ablation...
2015: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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