Technical tips for concomitant off-pump epicardial pulmonary vein isolation

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology

Background:

• Simultaneous treatment of coronary artery disease and atrial fibrillation is often necessary.
• Off-pump coronary artery bypass grafting (CABG) combined with epicardial pulmonary vein (PV) isolation is a less-invasive approach.
• Technical challenges exist in exposing and clamping the left PV during off-pump CABG on a beating heart.

Purpose of the Study:

• To describe a simplified technique for performing off-pump concomitant epicardial PV isolation.
• To address the technical difficulties associated with left PV manipulation during off-pump CABG.

Main Methods:

• Utilizing a tape passed through the transverse pericardial sinus.
• Performing epicardial PV isolation concurrently with off-pump CABG.
• Demonstrating technical tips for ease of execution on a beating heart.

Main Results:

• The described technique facilitates easier and safer epicardial PV isolation.
• Successful concomitant procedure achieved without cardiopulmonary bypass.
• Left PV exposure and manipulation were simplified.

Conclusions:

• The use of a tape through the transverse pericardial sinus is an effective technical tip for off-pump concomitant epicardial PV isolation.
• This method enhances the feasibility of minimally invasive simultaneous treatment for coronary artery disease and atrial fibrillation.