title: Septal-superior exposure in mitral valve surgery with radiofrequency ablation.
abstract: BACKGROUND
  We review the results of surgical radiofrequency ablation of both atria in patients of mitral valve disease approached by septal-superior exposure and discuss the availability of this approach.
  
  
  METHODS
  Eighteen patients with a mean age of 65 years were included in this study. Thirteen patients had mitral valve regurgitation predominantly and five had mitral valve stenosis. Eleven patients underwent mitral valve plasty and valve replacement was carried out in seven. All ablation lesions were created on both atria using radiofrequency energy delivered by a unipolar malleable radiofrequency ablation catheter with seven electrodes at a minimum temperature of 80-85 degrees C for a period of 2 min.
  
  
  RESULTS
  At the time of discharge, 14 patients were showed normal sinus rhythm and one patient remained in AF. The other three patients were free from atrial fibrillation; however, they received dual-mode, dual-pacing, dual-sensing pacemaker implantation because of bradycardia during the early postoperative phase. At a mean time of 7 months after surgery, all patients were free from atrial fibrillation; 13 patients showed normal sinus rhythm and five patients received dual-mode, dual-pacing, dual-sensing pacemakers.
  
  
  CONCLUSIONS
  Septal-superior exposure provides an excellent operative view both for mitral valve surgery and for radiofrequency ablation. However, this exposure has not been considered a first-line approach because of the high rate of pacemaker implantation.
authors.affiliation: Department of Cardiovascular Surgery, Teikyo University School on Medicine, Tokyo, Japan. ishikawa@med.teikyo-u.ac.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Tamiyuki
authors.initials: T
authors.lastname: Obayashi
authors.forename: Akio
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Neya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ohki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kugawa
authors.forename: Tamuro
authors.initials: T
authors.lastname: Hayama
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ueda
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000601:surgery