title: Outcomes of Surgical Atrial Fibrillation Ablation: The Port Access Approach vs. Median Sternotomy.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea.
authors.forename: Won Kyoun
authors.initials: WK
authors.lastname: Park
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Joon Bum
authors.initials: JB
authors.lastname: Kim
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Jung
authors.forename: Suk Jung
authors.initials: SJ
authors.lastname: Choo
authors.forename: Cheol Hyun
authors.initials: CH
authors.lastname: Chung