초록접수 현황
| 17F-003 | 구연 발표 |
Outcomes of Robotic Assisted Surgical Ablation of Atrial Fibrillation Combined with Mitral Valve Surgery
Chee-hoon Lee, Min Ho Ju, Joon Bum Kim, Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : In the era of expanding minimally invasive techniques in atrial fibrillation (AF) ablation surgery, data on robotic-assisted surgical AF ablation in patients undergoing mitral valve (MV) surgeries are scarce. The aim of this study is to evaluate early and late outcomes following robotic-assisted ablation of AF combined with MV surgery.
Methods : From 2007 through 2016, total 84 patients (54.0±13.1 years; 25 females) undergoing AF ablation using an argon-based flexible cryoablation system in the setting of MV operation under da Vinci robotic-assistance were enrolled. Persistent (N=34, 40.5%) or longstanding persistent (N=37, 44.0%) AF were present. Primary valve procedures were mitral repair in 51, mitral replacement in 1, and combined mitral- and tricuspid repair in 32.
Results : 50 patients (59.5%) received left-side-only AF ablation while the other (N=34, 40.5%) received biatrial ablation. Aortic cross clamping time was 133.2±29.3 minutes. There was no early mortality, re-exploration for bleeding, wound complication and permanent pacemaker implantation. Major early complications included neurologic injury in 1 and low cardiac output syndrome in 2. Early AF was identified in 20 (23.8%) patients during post-operative 3 onths. During a median follow-up duration of 47.5 months (Quartile 1-3, 19.2-78.3 months; 86.9% complete), 7 patients (8.3%) showed late recurrence of AF (after 90 days). One- and five-year rates of freedom from late AF were 96.4±2.1 % and 92.6±3.3% respectively. There were two cases of late death (0.6%/patient-year) and one patient experienced stroke (0.3%/patient-year).
Conclusion : Surgical AF ablation using robotic-assistance in the setting of cardiac valve surgeries showed excellent safety and favorable long-term clinical outcomes.
Methods : From 2007 through 2016, total 84 patients (54.0±13.1 years; 25 females) undergoing AF ablation using an argon-based flexible cryoablation system in the setting of MV operation under da Vinci robotic-assistance were enrolled. Persistent (N=34, 40.5%) or longstanding persistent (N=37, 44.0%) AF were present. Primary valve procedures were mitral repair in 51, mitral replacement in 1, and combined mitral- and tricuspid repair in 32.
Results : 50 patients (59.5%) received left-side-only AF ablation while the other (N=34, 40.5%) received biatrial ablation. Aortic cross clamping time was 133.2±29.3 minutes. There was no early mortality, re-exploration for bleeding, wound complication and permanent pacemaker implantation. Major early complications included neurologic injury in 1 and low cardiac output syndrome in 2. Early AF was identified in 20 (23.8%) patients during post-operative 3 onths. During a median follow-up duration of 47.5 months (Quartile 1-3, 19.2-78.3 months; 86.9% complete), 7 patients (8.3%) showed late recurrence of AF (after 90 days). One- and five-year rates of freedom from late AF were 96.4±2.1 % and 92.6±3.3% respectively. There were two cases of late death (0.6%/patient-year) and one patient experienced stroke (0.3%/patient-year).
Conclusion : Surgical AF ablation using robotic-assistance in the setting of cardiac valve surgeries showed excellent safety and favorable long-term clinical outcomes.
책임저자: Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Chee-hoon Lee, E-mail : liebemh@gmail.com