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A. Basics
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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
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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
37. Miscellanea
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CLEAR FILTERS
Surgical Ablation of Atrial Fibrillation and Left Appendage Occlusion by a Totally Videothoracoscopic Approach- A Paradigm shift?
Session:
Painel 5 -Arritmologia 2
Speaker:
Carolina Freire Rodrigues
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Carolina Rodrigues; Manuela Gouveia Silva; Rui Pedro Cerejo; Rui Rodrigues; Pedro Silva Cunha; Mário Martins Oliveira; José Fragata
Abstract
<p>Background: Atrial Fibrillation leads to increased morbidity and mortality. Pharmacological and catheter therapies are unsatisfactory and with serious adverse effects. Cox- Maze III/IV, with the highest rates of success, had not been widely adopted because of complexity and low reproducibility.</p> <p>Methods: We performed a descriptive analysis of the 15 patients that have been submitted to surgical ablation of atrial fibrillation and occlusion of the left appendage by a totally thoracoscopic approach, since we started using this technique in November 2017. 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, 12 and 18 months of follow-up. We aim to evaluate if the results in our institution are comparable with the results of high volume centers.</p> <p>Results: Of 15 patients, with ages between 39 and 75 years old, 53% (n=8) are female. The mean time since the diagnosis of atrial fibrillation was 5,75 years. All 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 mean hospital stay was 4,8 days. Mean time of follow-up is 12 months. All patients were maintained on anti-coagulation after the surgery. At one month of follow-up, 91% were in sinus rhythm. At 6 months follow- up, 90% were in sinus rhythm. At one year, 80% were in sinus rhythm. Between patients that achieved18 months of follow-up, 80% were in sinus rhythm.</p> <p>Conclusion: We believe it represents a real benefit for those with multiple attempts of catheter ablation without success. It is a reproducible technique and it has a fast learning curve with promising results, even in low volume centers. It may represent a paradigm shift but it demands an active program.</p>
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