Video-assisted minimally invasive cardiac surgery for atrial fibrillation: a report of 57 cases

Abstract

To evaluate the feasibility and the efficacy of a new video-assisted minimally invasive surgery for patients with atrial fibrillation (AF). From December 2006 to October 2007, 57 patients who were 56.4 years old in average underwent the video-assisted minimally invasive cardiac operation for AF, and there were 40 male patients. Thirty-eight patients were paroxysmal AF, 7 patients were persistent and 12 patients were long-standing persistent. Three patients had failed catheter ablation, and two patients had preoperative permanent pacemaker implantation. All patients went under the minimally invasive procedure. Intraoperative electrophysiological mapping were performed. Mean operation time was 3.5 h. One patient was confirmed of left auricle thrombus, and one received concurrent epicardial cardiac resynchronization therapy during the procedure. There were no perioperative deaths. Acute respiratory failure occurred in 1 patient and acute heart failure in 1 patient after operation. Sixteen patients had electrical cardioversion after operation and during follow-up. At discharge, 78.9% (45/57) of all patients were in sinus rhythm (84.2% for paroxysmal AF, 71.4% for persistent AF, 66.7% for long-standing persistent AF). The patients were followed-up by 1 to 10 months. At 1 month after operation, overall 64.3% (36/56) were in sinus rhythm (67.6% for paroxysmal AF, 57.1% for persistent AF, 58.3% for long-standing persistent AF). At 3 months, overall 83.9% (47/56) were in sinus rhythm (86.5% for paroxysmal AF, 85.7% for persistent AF, 75.0% for long-standing persistent AF). At > or = 6 months, overall 87.0% (20/23) were in sinus rhythm (89.5% for paroxysmal AF, 75.0% for persistent AF). No thromboembolic event was observed during follow-up period. The video-assisted minimally invasive cardiac surgery proves to be safe, less traumatic, and presents optimistic early outcomes for paroxysmal AF patients.