Abstract
BackgroundAlthough surgical ablation of atrial fibrillation is commonly performed during concomitant coronary or valve surgery, it is still only performed in a fraction these cases when indicated, and less often in patients undergoing aneurysm surgery. We describe our experience in patients undergoing ascending aneurysm repair and concomitant atrial fibrillation ablation.MethodsFrom January 2004 until November 2011, 40 patients underwent ascending aneurysm repair and atrial fibrillation ablation at our institution and were retrospectively analyzed.ResultsAverage age was 67.6 years (43–85). Root replacement was performed in 23 (57.5 %) and arch replacement with circulatory arrest in 18 (45 %). At an average of 41.8 months, 81 % of patients were in sinus rhythm. Operative survival was 100 %, with 1 and 5 year survival of 97.5 and 93.1 %, respectively. Kaplan-Meier analysis revealed improved overall survival in patients with rhythm success (log-rank test p = 0.037).ConclusionsAortic aneurysm repair with concomitant atrial fibrillation ablation is safe and efficacious despite the requirement for an already extensive procedure with rhythm success rates similar to those quoted in the setting of other procedures. Successful restoration of sinus rhythm improves long term survival and should be considered in patients presenting with aortic aneurysm and atrial fibrillation.
Highlights
Surgical ablation of atrial fibrillation is commonly performed during concomitant coronary or valve surgery, it is still only performed in a fraction these cases when indicated, and less often in patients undergoing aneurysm surgery
Mitral valve repair/replacement (MVR) is most commonly associated with surgical Atrial fibrillation (AF) ablation as these patients have frequently developed the substrate for AF and exposure is complimentary [7]
Aneurysm surgery is less commonly performed with surgical AF ablation, likely due to the less common association of the two disease states and the perception of an assumed increase in risk of an already extensive procedure
Summary
Surgical ablation of atrial fibrillation is commonly performed during concomitant coronary or valve surgery, it is still only performed in a fraction these cases when indicated, and less often in patients undergoing aneurysm surgery. We describe our experience in patients undergoing ascending aneurysm repair and concomitant atrial fibrillation ablation. Mitral valve repair/replacement (MVR) is most commonly associated with surgical AF ablation as these patients have frequently developed the substrate for AF (i.e. left atrial dilation) and exposure is complimentary [7]. Aneurysm surgery is less commonly performed with surgical AF ablation, likely due to the less common association of the two disease states and the perception of an assumed increase in risk of an already extensive procedure. We describe our experience in 40 patients undergoing ascending aneurysm repair and concomitant surgical AF ablation with the goal of demonstrating safety and efficacy
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