[New perspectives on the surgical treatment of atrial fibrillation. From extracorporeal circulation surgery to minimally invasive heart surgery].
Atrial fibrillation remains the most common sustained tachyarrhythmia, with recurrent symptoms and thromboembolic risks. In the last few years it has become the recent focus of intense clinical and experimental interest which confirm that this arrhythmia is due to atrial re-entry mechanisms. With better understanding of its physiopathology, an efficient surgical treatment has been developed. Surgical interventions of supraventricular tachycardias is targeted to neutralize the arrhythmogenic disorder using exclusion or ablation. Several methods can be used like surgical incisions, cryoablation, radiofrequency ablation or laser energy. Surgery being a transparietal approach requiring cardiopulmonary bypass, atriotomy and myocardial preservation, associated morbidity is due to the high technicalities of this treatment and not necessarily the therapy itself. New developments in the surgical approach tend to avoid cardiopulmonary bypass to reduce morbidity. The aim of this review is to describe and report our own experiences in this evolving domain of atrial fibrillation surgery.
Ruchat
P
P
Service de chirurgie cardio-vasculaire, CHUV, Lausanne. Patrick.Ruchat@chuv.hospvd.ch
Schlaepfer
J
J
Fromer
M
M
Chassot
P G
PG
von Segesser
L K
LK
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged