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J Cardiovasc Surg (Torino). 2021 Feb;62(1):87-94. doi: 10.23736/S0021-9509.20.11156-X. Epub 2020 Sep 10.
Minimally invasive access via partial sternotomy has been established for aortic valve surgery in the past years. But concomitant procedures like atrial ablation and aortic valve replacement via partial upper sternotomy have not been investigated so far. We therefore present our operative technique and results in terms of safety and efficacy, including follow-up and quality of life.
Between February 2007 and March 2014 a total of 67 patients undergoing isolated minimally invasive aortic valve replacement received concomitant left atrial ablation at our centre. Operative technique and short- and midterm results are described, including quality of life assessment using the SF-36 questionnaire.
Operative techniqual success rate was 98.5%. We observed only one (1.5%) ablation-related conversion to full sternotomy. Operative times, reexploration and stroke rates as well as 30-day mortality are comparable to open procedures. Efficacy: The proportions of patients in sinus rhythm at discharge was 54.5% for paroxysmal AF patients and 27.7% overall. After a mean follow-up time of 38.0±22.6 months the cardiac related mortality rate was 4.5%, the rate of sinus rhythm was 72.7% for paroxysmal AF patients and 36.8% overall. Of survivors, overall mean quality of life was 7.3±2.1 as measured by SF-36.
Concomitant left atrial ablation and aortic valve replacement can safely be performed via partial sternotomy and results are non-inferior to open surgery.
微创经胸骨部分切开术已在过去几年中被确立用于主动脉瓣手术。但目前尚未研究经胸骨部分上切开术同期进行的其他手术，如心房消融和主动脉瓣置换术。因此，我们介绍了我们的手术技术和安全性及有效性结果，包括随访和生活质量。
2007 年 2 月至 2014 年 3 月，共有 67 例接受孤立性微创主动脉瓣置换术的患者在我们中心接受了同期左心房消融术。描述了手术技术和短期及中期结果，包括使用 SF-36 问卷评估生活质量。
手术技术成功率为 98.5%。我们仅观察到 1 例（1.5%）消融相关的转为全胸骨切开术。手术时间、再次探查和中风率以及 30 天死亡率与开放手术相当。疗效：阵发性 AF 患者出院时窦性心律的比例为 54.5%，总体为 27.7%。平均随访 38.0±22.6 个月后，心脏相关死亡率为 4.5%，阵发性 AF 患者的窦性心律率为 72.7%，总体为 36.8%。在幸存者中，总体平均生活质量为 7.3±2.1，通过 SF-36 测量。
同期左心房消融和主动脉瓣置换术可通过部分胸骨切开术安全进行，结果不劣于开放手术。
