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KMID : 0364020120450010011
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Korean Journal of Thoracic and Cardiovascular Surgery
2012 Volume.45 No. 1 p.11 ~ p.18
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Outcomes of Surgical Atrial Fibrillation Ablation: The Port Access Approach vs. Median Sternotomy
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Park Won-Kyoun
Lee Jae-Won
Kim Joon-Bum
Jung Sung-Ho
Choo Suk-Jung
Chung Cheol-Hyun
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Abstract
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Background: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases.
Materials and Methods: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups’ baseline characteristics, a propensity score analysis was performed.
Results: After adjustment, there were no significant differences in the two groups’ baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group (176.0±49.5 minutes) than the sternotomy group (150.0±51.9 minutes). There were no significant differences (p=0.31) in the two groups’ rate of reoperation for bleeding (MICS=6 vs. sternotomy=2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were 87.4±8.1% in the MICS group and 89.6±5.8% in the sternotomy group (p=0.92). Freedom from late AF at 2 years was 86.8±6.2% in the MICS group and 85.0±6.9% in the sternotomy group (p=0.86).
Conclusion: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.
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KEYWORD
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Arrhythmia surgery, Minimally invasive surgery, Mitral valve, Atrial fibrillation
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