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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
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Surgical ablation of atrial fibrillation by a totally videothoracoscopic approach- new paradigm ?
Session:
Posters 2 - Écran 6 - Arritmologia
Speaker:
Carolina Freire Rodrigues
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Carolina Rodrigues; Rui Pedro Cerejo; Manuela Gouveia Silva; Rui Rodrigues; José Fragata
Abstract
<p>Maze surgery is still a time-consuming invasive procedure, that requires extra-corporeal circulation. Catheter ablation presents highly variable rates of success. Surgical ablation of atrial fibrillation by a totally videothoracoscopic approach, using radiofrequency, is a recent alternative, that we performed for the first time at November of 2017. We performed a descriptive analyses of the 13 patients that have been submitted to surgical ablation of atrial fibrillation and occlusion of the left appendage by a totally thoracoscopic approach. We describe the surgical technique and our results, including duration of surgery, hospital stay, complications and conversion to sinus rhythm immediately after surgery, at one month, 6 and 12 months of follow-up. Of the 13 patients, with ages between 39 and 75 years old, 46% (n=6) are male. The mean time since the diagnosis of atrial fibrillation was 5,75 years. Almost all (n=12) had been submitted to prior catheter ablation (mean of 2 attempts). The mean diameter and volume of left atrium was 42 mm and 70 ml (43 ml/m2). The mean duration of surgery was 2hours and 22 minutes. In only one patient we had to convert to a median sternotomy. The procedure was not possible to perform in one patient. Conversion to sinus rhythm and left atrial occlusion was obtained in all patients. Pacemaker implantation was needed in one patient. The mean hospital stay was 5 days. Mean time of follow-up is 8 months. All patients were maintained on anti-coagulation after the surgery. Patients under anti-arrhythmic drugs pre-operatively, were maintained on anti-arrhythmic after the surgery. At one month follow-up, 91% (n=10) were in sinus rhythm. At 6 months follow- up, 90% (n=9) were in sinus rhythm. At November 2018, 4 patients complete 1 year of follow-up. Of those, one has already been evaluated, maintaining sinus rhythm. We are aware of the small dimensions of this population ant short period of follow up. However, these results seem to represent a real benefit for those patients with multiple attempts of catheter ablation without success. This approach needs to be supported by a multidisciplinary team- the so called arrythmia team- before, during and after the surgery.</p>
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