Minimally invasive cardiac surgery for atrial fibrillation complicated by coronary artery disease: combination of video-assisted pulmonary vein isolation and minimally invasive direct coronary artery bypass.
Here we report a minimally invasive cardiac surgery procedure without sternotomy combining video-assisted bilateral pulmonary vein isolation and minimally invasive direct coronary artery bypass as treatment for atrial fibrillation complicated by coronary artery disease. The patient's chest was accessed through a left anterolateral thoracotomy over the fourth intercostal space, and the left internal thoracic artery (LITA) was harvested under direct vision. The left pulmonary veins were isolated electrically by a bipolar radiofrequency clamp. Subsequently, the harvested LITA graft was anastomosed to the left anterior descending artery. Right pulmonary vein isolation was then performed through a small thoracotomy at the right fourth intercostal region in the same manner as the left side. A linear block on the left atrial roof, connecting the lesions encircling the left and right pulmonary veins, was created from both sides by a pen-like bipolar radiofrequency.
Totsugawa
Toshinori
T
Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Marunouchi, Japan. toshinoritotsugawa@mac.com
Kuinose
Masahiko
M
Nishigawa
Kosaku
K
Yoshitaka
Hidenori
H
Tsushima
Yoshimasa
Y
Ishida
Atsuhisa
A
D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome