Abstract
A partial lower inverted J sternotomy and an extended transseptal incision provide excellent exposure for minimally invasive mitral valve surgery. However, the extended trasnsseptal incision causes dividing the sinus node artery, which may result in conduction system disturbance and need for permanent pacemaker implantation. Therefore, there is a challenge in the patient who requires concomitant ablation for atrial fibrillation because of possible conduction system disturbance caused by extended transseptal incision. We describe a new strategy for combined ablation of atrial fibrillation with minimally invasive cardiac surgery by a transseptal approach to the mitral valve through a partial lower sternotomy incision. Cryoablation was performed using a T-shaped cryoprobe with a lesion set of pulmonary vein isolation and ablation of the left and right isthmus in performing mitral annuloplasty, tricuspid annuloplasty, and atrial septal defect closure through a limited sternotomy incision. This technique might minimize possible conduction system disturbance and provide good surgical result for the patients who undergo mitral valve surgery and ablation of atrial fibrillation.
Highlights
Invasive cardiac surgery with partial sternotomy for valvular heart disease has been performed for more than a decade
There is a challenge in the patient who requires combined ablation of atrial fibrillation because of possible conduction system disturbance caused by the extended transseptal approach
We carried out cryoablation in three patients for chronic atrial fibrillation with good clinical results using a T-shaped cryoprobe with a lesion set of pulmonary vein isolation and ablation of the left and right isthmus in performing minimally invasive mitral valve surgery
Summary
Invasive cardiac surgery with partial sternotomy for valvular heart disease has been performed for more than a decade. A partial lower sternotomy and an extended transseptal incision provide excellent exposure for minimally invasive mitral valve surgery [1,2]. We carried out cryoablation in three patients for chronic atrial fibrillation with good clinical results using a T-shaped cryoprobe with a lesion set of pulmonary vein isolation and ablation of the left and right isthmus in performing minimally invasive mitral valve surgery. Case report A 72-year-old man with a history of chronic atrial fibrillation recently experienced palpitation and dyspnea on effort His echocardiography showed an atrial septal defect, moderate mitral regurgitation, moderate tricuspid regurgitation, and slightly reduced left ventricular function with an ejection fraction of 49%. He has maintained normal sinus rhythm for one year postoperatively without antiarrhythmic medication
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
