Outcomes of Surgical Atrial Fibrillation Ablation: The Port Access Approach vs. Median Sternotomy

• Published in: The Korean journal of thoracic and cardiovascular surgery 2012-02, Vol.45 (1), p.11-18
• Main Authors: Park, Won Kyoun, Lee, Jae Won, Kim, Joon Bum, Jung, Sung-Ho, Choo, Suk Jung, Chung, Cheol Hyun
• Format: Article
• Language: English
• Subjects: Clinical Research
• ISSN: 2233-601X; 2093-6516
• DOI: 10.5090/kjtcs.2012.45.1.11

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. 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. 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). Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.