[Application of cryoablation in 
minimally invasive mitral valve surgery].

OBJECTIVE: To summarize the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery and to explore safety and effectiveness of the surgery.


METHODS: We retrospectively collected the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery in Department of Cardiovascular of Second Xiangya Hospital from August 2013 to July 2015. Through a right side (4-6 cm) thoracotomy, femoral cannulation and aortic cross-clamp by Chitwood clamper was performed, left atrium was entered from interatrial groove. Modified left and right side cryomaze followed by valve surgery was finished. The left atrial appendage was excluded by oversewing from endocardial surface. The cardiopulmonary bypass time, cross-clamp time, duration in hospital were recorded. The heart rhythm of 3 consecutive post operation days, at 7th day, 3 months, 6 months, 12 months or 18 months after the surgery was monitered by 12-leads electrical cardiogram.


RESULTS: No death was observed in this group. Reexploration for bleeding was conducted for one case. Operation time, CBP time and cross-clamp time was (197.4±27.2), (103.6±20.3)and (65.3±15.7) min, respectively. Duration in ICU and hospital was (1.2±0.4) and (9.2±1.6) d, respectively. The ratio of sinus rhythm restoration right after surgery was 97.1%. The ratio of sinus rhythm restoration at the time of hospital discharge was 94.3%. No motality was found in follow-up. The ratio of sinus rhythm restoration at 3, 6, 12,18 months after the surgery was 94.3%, 93.5%, 90.5%, 93.3%, respectively.


CONCLUSION: Right minimal invasive thoracoscopic-assisted cryoablation in mitral valve surgery is quite effective in the treatment of atrial fibrillation, displaying the advantages of less complications, motality and hospitalization.