Mei Mini Maze Procedure for 207 Patients with Atrial Fibrillation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MANan , JIANGZhao-lei , CHENFei , ZHAONai-shi , DINGFang-bao ,  MEIJu

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, P. R. China;

Corresponding?author：

MEIJu, Email: ju_mei63@126.com

Keywords：

Atrial fibrillation; Minimal invasive surgery; Ablation

DOI：

10.7507/1007-4848.20150249

Video：

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Objective To explore the effectiveness and safety of Mei mini maze procedure for atrial fibrillation (AF). Methods We analyzed the clinical data of 207 patients with 111 males, 96 females at 58.9±14.8 years in our hospital between October 2010 and February 2014. Among them, 98 patients were with paroxysmal AF and 109 patients were with persistent AF. The procedure was performed through three ports on left chest wall. Radiofrequency ablation procedures of AF included pulmonary veins isolation and ablations of the roof and posterior wall of left atrium, which were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was made by the ablation pen. Left atrial appendage was excluded. Results Time of the procedures was 112.4±32.5 minutes. No conversion to sternotomy or pacemaker implantation occurred and no patients died. The hospital stay was 7.2±3.1days. The mean follow-up time was 24.2±8.9 months. A total of 187 (90.3%) patients were in sinus rhythm. And 20 patients could not maintain sinus rhythm. Stroke, thrombus in the left atrium and stenosis of pulmonary vein were not found after their procedures. Conclusion Mei mini maze procedure is safe and presents optimistic outcomes for the atrial fibrillation.

Citation： MANan, JIANGZhao-lei, CHENFei, ZHAONai-shi, DINGFang-bao, MEIJu. Mei Mini Maze Procedure for 207 Patients with Atrial Fibrillation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(11): 996-999. doi: 10.7507/1007-4848.20150249 Copy

1.	Zhou Z,Hu D.An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China.J Epidemiol,2008,18(5):209-216.
2.	Martinez C,Katholing A,Wallenhorst C,et al.Increasing incidence of non-valvular atrial fibrillation in the UK from 2001 to 2013.Heart,2015,Aug 25.doi:10.1136/heartjnl-2015-307808.
3.	McCabe PJ,Rhudy LM,Chamberlain AM,et al.Fatigue,dyspnea,and intermittent symptoms are associated with treatment-seeking delay for symptoms of atrial fibrillation before diagnosis.Eur J Cardiovasc Nurs,2015 Aug 28.pii:1474515115603901.
4.	Alli O,Holmes DR Jr.Left atrial appendage occlusion for stroke prevention.Curr Probl Cardiol,2012,37(10):405-441.
5.	January CT,Wann LS,Alpert JS,et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:executive summary:a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society.Circulation,2014,130(23):2071-2104.
6.	Mei J,Ma N,Ding F,et al.Complete thoracoscopic ablation of the left atrium via the left chest for treatment of lone atrial fibrillation.J Thorac Cardiovasc Surg,2014,147(1):242-246.
7.	馬南,梅舉,丁芳寶,等.左胸徑路微創外科治療孤立性房顫.中華胸心血管外科雜志,2013,29(11):692-693.
8.	Camm AJ,Kirchhof P,Lip GY,et al.Guidelines for the management of atrial fibrillation:the task force for the management of atrial fibrillation of the European Society of Cardiology(ESC).Eur Heart J,2010,32(9):2369-2429.
9.	Ma N,Ding F,Jiang Z,et al.Totally endoscopic ablation of left atrium via left chest for lone atrial fibrillation.Innovations(Phila),2012,7(5):382-384.
10.	Scherr D,Jais P.Atrial fibrillation:AF prognosis and treatment——the European perspective.Nat Rev Cardiol,2014,11(12):689-690.
11.	Rolf S,Kornej J,Dagres N,et al.What can rhythm control therapy contribute to prognosis in atrial fibrillation?Heart,2015,101(11):842-846.
12.	Lewalter T,Ibrahim R,Albers B,et al.An update and current expert opinions on percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation.Europace,2013,15(5):652-656.
13.	Crandall MA,Bradley DJ,Packer DL,et al.Contemporary management of atrial fibrillation:update on anticoagulation and invasive management strategies.Mayo Clin Proc,2009,84(7):643-662.
14.	Wolf RK,Schneeberger EW,Osterday R,et al.Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation.J Thorac Cardiovasc Surg,2005,130(3):797-802.
15.	Yilmaz A,Geuzebroek GS,Van Putte BP,et al.Completely thoracoscopic pulmonary vein isolation with ganglionic plexus ablation and left atrial appendage amputation for treatment of atrial fibrillation.Eur J Cardiothorac Surg,2010,38(3):356-360.
16.	Andrade JG,Macle L.Improving ablation strategies for the treatment of atrial fibrillation.Expert Rev Med Devices,2014,11(1):77-88.
17.	Benussi S,Nascimbene S,Calori G,et al.Surgical ablation of atrial fibrillation with a novel bipolar radiofrequency device.J Thorac Cardiovasc Surg,2005,130(2):491-497.
18.	Wisser W,Seebacher G,Fleck T,et al.Permanent chronic atrial fibrilltion:is pulmonary vein isolation alone enough.Ann Thorac Surg,2007,84(4):1151-1157.
19.	Gallagher AM,Setakis E,Plumb JM,et al.Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients.Thromb Haemost,2011,106(5):968-977.
20.	Cox JL.Mechanical closure of the left atrial appendage:is it time to be more aggressive?J Thorac Cardiovasc Surg,2013,146(5):1018-1027.
21.	Ohtsuka T,Ninomiya M,Nonaka T,et al.Thoracoscopic standalone left atrial appendectomy for thromboembolism prevention in nonvalvular atrial fibrillation.J Am Coll Cardiol,2013,62(2):103-107.

1. Zhou Z,Hu D.An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China.J Epidemiol,2008,18(5):209-216.
2. Martinez C,Katholing A,Wallenhorst C,et al.Increasing incidence of non-valvular atrial fibrillation in the UK from 2001 to 2013.Heart,2015,Aug 25.doi:10.1136/heartjnl-2015-307808.
3. McCabe PJ,Rhudy LM,Chamberlain AM,et al.Fatigue,dyspnea,and intermittent symptoms are associated with treatment-seeking delay for symptoms of atrial fibrillation before diagnosis.Eur J Cardiovasc Nurs,2015 Aug 28.pii:1474515115603901.
4. Alli O,Holmes DR Jr.Left atrial appendage occlusion for stroke prevention.Curr Probl Cardiol,2012,37(10):405-441.
5. January CT,Wann LS,Alpert JS,et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:executive summary:a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society.Circulation,2014,130(23):2071-2104.
6. Mei J,Ma N,Ding F,et al.Complete thoracoscopic ablation of the left atrium via the left chest for treatment of lone atrial fibrillation.J Thorac Cardiovasc Surg,2014,147(1):242-246.
7. 馬南,梅舉,丁芳寶,等.左胸徑路微創外科治療孤立性房顫.中華胸心血管外科雜志,2013,29(11):692-693.
8. Camm AJ,Kirchhof P,Lip GY,et al.Guidelines for the management of atrial fibrillation:the task force for the management of atrial fibrillation of the European Society of Cardiology(ESC).Eur Heart J,2010,32(9):2369-2429.
9. Ma N,Ding F,Jiang Z,et al.Totally endoscopic ablation of left atrium via left chest for lone atrial fibrillation.Innovations(Phila),2012,7(5):382-384.
10. Scherr D,Jais P.Atrial fibrillation:AF prognosis and treatment——the European perspective.Nat Rev Cardiol,2014,11(12):689-690.
11. Rolf S,Kornej J,Dagres N,et al.What can rhythm control therapy contribute to prognosis in atrial fibrillation?Heart,2015,101(11):842-846.
12. Lewalter T,Ibrahim R,Albers B,et al.An update and current expert opinions on percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation.Europace,2013,15(5):652-656.
13. Crandall MA,Bradley DJ,Packer DL,et al.Contemporary management of atrial fibrillation:update on anticoagulation and invasive management strategies.Mayo Clin Proc,2009,84(7):643-662.
14. Wolf RK,Schneeberger EW,Osterday R,et al.Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation.J Thorac Cardiovasc Surg,2005,130(3):797-802.
15. Yilmaz A,Geuzebroek GS,Van Putte BP,et al.Completely thoracoscopic pulmonary vein isolation with ganglionic plexus ablation and left atrial appendage amputation for treatment of atrial fibrillation.Eur J Cardiothorac Surg,2010,38(3):356-360.
16. Andrade JG,Macle L.Improving ablation strategies for the treatment of atrial fibrillation.Expert Rev Med Devices,2014,11(1):77-88.
17. Benussi S,Nascimbene S,Calori G,et al.Surgical ablation of atrial fibrillation with a novel bipolar radiofrequency device.J Thorac Cardiovasc Surg,2005,130(2):491-497.
18. Wisser W,Seebacher G,Fleck T,et al.Permanent chronic atrial fibrilltion:is pulmonary vein isolation alone enough.Ann Thorac Surg,2007,84(4):1151-1157.
19. Gallagher AM,Setakis E,Plumb JM,et al.Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients.Thromb Haemost,2011,106(5):968-977.
20. Cox JL.Mechanical closure of the left atrial appendage:is it time to be more aggressive?J Thorac Cardiovasc Surg,2013,146(5):1018-1027.
21. Ohtsuka T,Ninomiya M,Nonaka T,et al.Thoracoscopic standalone left atrial appendectomy for thromboembolism prevention in nonvalvular atrial fibrillation.J Am Coll Cardiol,2013,62(2):103-107.

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