Related Experiment Videos
Atrial compartment surgery for chronic atrial fibrillation associated with congenital heart defects
1Department of Surgery, College of Medicine, National Taiwan University, Taipei.
Insights
Atrial compartment surgery effectively eliminated chronic atrial fibrillation in three patients with congenital heart defects. This procedure restored normal sinus rhythm and atrial contractility, offering a simple solution for complex cardiac conditions.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Chronic atrial fibrillation is a common complication in patients with congenital heart defects.
- Surgical intervention for congenital heart defects often necessitates addressing concomitant arrhythmias.
- Existing treatments for atrial fibrillation in this population may have limitations.
Abstract:
In three adult patients, two with atrial septal defect and one with Ebstein's anomaly, chronic atrial fibrillation was documented for 13, 21, and 3 years, respectively. Atrial compartment surgery was performed for ablation of the atrial fibrillation concomitant with repair of the cardiac defects. The operation was performed with traditional cardiopulmonary bypass and crystalloid cardioplegia myocardial protection. A U-shaped incision was made in the right atrium: a longitudinal incision 1 cm lateral and parallel to the sulcus terminalis, extending along the borders of the atrial septum to 3 cm (upper margin) and 1 cm (lower margin) distant to the tricuspid anulus. Cryolesions of the atrial isthmus between the upper incision margin and the tricuspid valve anulus were created at -60 degrees C for 180 seconds at a time. After the operation, all three patients had restored and maintained normal sinus rhythm during follow-up periods of 32, 16, and 3 months. Doppler echocardiography detected the recovery of atrial contractility in all three patients. Atrial compartment surgery is a simple and effective method for elimination of chronic atrial fibrillation associated with congenital heart defects.