Biatrial Cox Maze Cryoablation Procedure Concomitant to Minimally Invasive Valve Surgery through Right Lateral Minithoracotomy

Ju Mei, Zhaolei Jiang, Min Tang, Nan Ma, Hao Liu

Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–A

Abstract

Objective: To evaluate the safety and efficacy of biatrial Cox Maze Ⅳ cryoablation for atrial fibrillation (AF) during concomitant minimally invasive valve surgery. 

Methods: Forty seven patients (female n=21, age 42~69 years) with mitral valve disease and long-standing persistent AF received minimally invasive biatrial Cox Maze Ⅳ cryoablation procedure combined with mitral valve surgery through right minithoracotomy from January 2014 to September 2015. The etiology of mitral valve disease was rheumatic (n=31) and degenerative (n=16). AF duration ranged from 2 years to 11 years. Diameter of the left atrium ranged from 43 to 60 mm. Concomitant biatrial Cox Maze Ⅳ cryoablation procedure was performed through right lateral minithoracotomy. 

Results: All 47 patients successfully underwent this minimally invasive concomitant biatrial Cox Maze Ⅳ cryoablation procedure and valve surgery. No patient needed conversion to sternotomy during the surgery. The mean cardiopulmonary bypass time was 120.3±12.3 minutes. The mean aortic crossclamp time was 93.3±7.7 minutes. The mean cryoablation time was 38.6±4.5 minutes. There was no early death in the perioperation. The average length of postoperative hospital stay was 7.9±1.9 days. At discharge, 44 patients (44/47, 93.6%) maintained sinus rhythm. At a mean follow-up time of 26.5±6.8 months, sinus rhythm was restored in 39 patients (39/47, 83.0%). 

Conclusions: Biatrial Cox Maze Ⅳ cryoablation procedure was safe, feasible and effective for AF during concomitant minimally invasive valve surgery.