Abstract 18025: Cryomaze for Sole-Therapy Atrial Fibrillation
Objectives: Surgical AF treatment program was started at our institution in August 2008. We report our initial results using minithoracotomy approach for endocardial cryomaze.
Methods: All 30 patients undergoing Cryomaze between 8/08 and 12/10 are included. 1 patient underwent MVR while two others needed sternotomy for incidental aortic aneurysm and coronary artery disease diagnosed during preoperative workup. Surgical technique consisted of femoral cannulation for cardiopulmonary bypass and right mini-thoracotomy with video-assistance. Aortic root vent used in all cases and Chitwood clamp was used in arrested heart cases. On the left side, all pulmonary veins were isolated as an island and another line was made to the mitral annulus (LA isthmus line). On the right side, SVC was connected to IVC and this line was connected to tricuspid annulus (RA isthumus line). Left atrial appendage was oversewn in two layers, except during sternotomy, where it was stapled off with endo-GIA stapler. Beta blockers were used as tolerated and amiodarone was only used if patient developed AF. Postprocedure follow-up included spot EKG at 1, 3, 6 and 12 months and yearly thereafter. Symptomatic patients underwent three week continuous rhythm monitoring.
Results: Outcomes are given in table below. 4(13%) patients required permanent pacemakers. There were 6 (20%) complications including catheter ablation for atrial tachycardia, pericardial effusion (no intervention needed), subcutaneous emphysema, lung hernia, femoral lymph leak and reopening of one LAA. There were no mortalities or strokes.
Conclusions: Minimally invasive Cryomaze has acceptable morbidity and excellent short-term results in treating AF. Freedom from AF in this series was not influenced by left atrial vs biatrial ablation, beating heart vs arrested heart ablation, primary vs prior failed catheter ablation, or Paroxysmal vs Persistent AF.
- © 2011 by American Heart Association, Inc.