Long-term outcomes of surgical closure of atrial septal defects and concomitant surgical radiofrequency ablation for atrial fibrillation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 HAN Bo , WANG Junjie

Department of Cardiothoracic Surgery, Baogang Hospital, Baotou, 014010, Inner Mongolia, P.R.China;

Corresponding author：

HAN Bo, Email: 83524181@qq.com

Keywords：

Atrial septal defect; atrial fibrillation; radiofrequency ablation; long-term outcomes

DOI：

10.7507/1007-4848.201608004

Video：

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Objective To evaluate long-term outcomes of surgical closure of atrial septal defect (ASD) and combined surgical radiofrequency ablation for atrial fibrillation (AF). Methods A total of consecutive 15 patients with ASD undergoing surgical closure of ASD and combined surgical radiofrequency ablation in our department between March 2003 and April 2015. There were 7 males and 8 females at an average age of 47.1±10.8 years ranging from 16 to 62 years. Retrospective analysis and follow-up were performed to evaluate long-term success rate freedom from AF after surgery. Results All patients recovered and discharged, and no patient suffered death or stroke. The duration of follow-up was from 3 to 136 months for all patients. Success rate freedom from AF at 1, 3, 5 and 10 years was 81.3%, 75.0%, 68.8% and 61.1%, respectively. During follow-up, there was no death or stroke. One patient required permanent pacemaker implantation. Conclusion Concomitant surgical closure of ASD and biatrial radiofrequency ablation is safe and effetive with better long-term outcomes. It is necessary to perform the two procedures together for ASD patients.

Citation： HAN Bo, WANG Junjie. Long-term outcomes of surgical closure of atrial septal defects and concomitant surgical radiofrequency ablation for atrial fibrillation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(10): 779-782. doi: 10.7507/1007-4848.201608004 Copy

1.	Gatzoulis MA, Freeman MA, Siu SC, et al. Atrial arrhythmia after surgical closure of atrial septal defects in adults. N Engl J Med, 1999, 340(11): 839-846.
2.	Mantovan R, Gatzoulis MA, Pedrocco A, et al. Supraventricular arrhythmia before and after surgical closure of atrial septal defects: spectrum, prognosis and management. Europace, 2003; 5(2): 133-138.
3.	January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 2014; 64(21): e1-e76.
4.	Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J, 2012; 33(21): 2719-2747.
5.	Stulak JM, Dearani JA, Puga FJ, et al. Right-sided Maze procedure for atrial tachyarrhythmias in congenital heart disease. Ann Thorac Surg, 2006; 81(5): 1780-1784.
6.	Theodoro DA, Danielson GK, Porter CJ, et al. Right-sided maze procedure for right atrial arrhythmias in congenital heart disease. Ann Thorac Surg, 1998, 65(1): 149-153.
7.	Im YM, Kim JB, Yun SC, et al. Arrhythmia surgery for atrial fibrillation associated with atrial septal defect: right-sided maze versus biatrial maze. J Thorac Cardiovasc Surg, 2013; 145(3): 648-654.
8.	Jiang Z, Ma N, Yin H, et al. Biatrial ablation versus limited right atrial ablation for atrial fibrillation associated with atrial septal defect in adults. Surg Today, 2015, 45(7): 858-863.
9.	张润生. 双心房或单纯右心房射频消融术治疗成人先天性心脏病房间隔缺损合并心房颤动的对比研究. 中外医学研究, 2015, 13(20): 49-50.0.
10.	Perloff JK. Surgical closure of atrial septal defect in adults. N Engl J Med, 1995, 333(8): 513-514.
11.	Berger F, Vogel M, Kramer A, et al. Incidence of atrial flutter/fibrillation in adults with atrial septal defect before and after surgery. Ann Thorac Surg, 1999, 68(1): 75-78.
12.	Brandenburg RO Jr, Holmes DR Jr, Brandenburg RO, et al. Clinical follow-up study of paroxysmal supraventricular tachyarrhythmias after operative repair of a secundum type atrial septal defect in adults. Am J Cardiol, 1983, 51(2): 273-276.
13.	Shim H, Yang JH, Park PW, et al. Efficacy of the maze procedure for atrial fibrillation associated with atrial septal defect. Korean J Thorac Cardiovasc Surg, 2013, 46(2): 98-103.
14.	Soni LK, Cedola SR, Cogan J, et al. Right atrial lesions do not improve the efficacy of a complete left atrial lesion set in the surgical treatment of atrial fibrillation, but they do increase procedural morbidity. J Thorac Cardiovasc Surg, 2013, 145(2): 356-361.
15.	Worku B, Pak SW, Cheema F, et al. Incidence and predictors of pacemaker placement after surgical ablation for atrial fibrillation. Ann Thorac Surg, 2011, 92(6): 2085-2089.
16.	Gammie JS, Haddad M, Milford-Beland S, et al. Atrial fibrillation correction surgery: lessons from the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg, 2008, 85(3): 909-914.
17.	Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation: impact of the maze procedure. Circulation, 2012, 125(17): 2071-2080.
18.	Al-Saady NM, Obel OA, Camm AJ. Left atrial appendage: structure, function, and role in thromboembolism. Heart, 1999, 82(5): 547-554.
19.	Holmes DR Jr, Doshi SK, Kar S, et al. Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: A patient-level meta-analysis. J Am Coll Cardiol, 2015, 65(24): 2614-2623.

1. Gatzoulis MA, Freeman MA, Siu SC, et al. Atrial arrhythmia after surgical closure of atrial septal defects in adults. N Engl J Med, 1999, 340(11): 839-846.
2. Mantovan R, Gatzoulis MA, Pedrocco A, et al. Supraventricular arrhythmia before and after surgical closure of atrial septal defects: spectrum, prognosis and management. Europace, 2003; 5(2): 133-138.
3. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 2014; 64(21): e1-e76.
4. Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J, 2012; 33(21): 2719-2747.
5. Stulak JM, Dearani JA, Puga FJ, et al. Right-sided Maze procedure for atrial tachyarrhythmias in congenital heart disease. Ann Thorac Surg, 2006; 81(5): 1780-1784.
6. Theodoro DA, Danielson GK, Porter CJ, et al. Right-sided maze procedure for right atrial arrhythmias in congenital heart disease. Ann Thorac Surg, 1998, 65(1): 149-153.
7. Im YM, Kim JB, Yun SC, et al. Arrhythmia surgery for atrial fibrillation associated with atrial septal defect: right-sided maze versus biatrial maze. J Thorac Cardiovasc Surg, 2013; 145(3): 648-654.
8. Jiang Z, Ma N, Yin H, et al. Biatrial ablation versus limited right atrial ablation for atrial fibrillation associated with atrial septal defect in adults. Surg Today, 2015, 45(7): 858-863.
9. 张润生. 双心房或单纯右心房射频消融术治疗成人先天性心脏病房间隔缺损合并心房颤动的对比研究. 中外医学研究, 2015, 13(20): 49-50.0.
10. Perloff JK. Surgical closure of atrial septal defect in adults. N Engl J Med, 1995, 333(8): 513-514.
11. Berger F, Vogel M, Kramer A, et al. Incidence of atrial flutter/fibrillation in adults with atrial septal defect before and after surgery. Ann Thorac Surg, 1999, 68(1): 75-78.
12. Brandenburg RO Jr, Holmes DR Jr, Brandenburg RO, et al. Clinical follow-up study of paroxysmal supraventricular tachyarrhythmias after operative repair of a secundum type atrial septal defect in adults. Am J Cardiol, 1983, 51(2): 273-276.
13. Shim H, Yang JH, Park PW, et al. Efficacy of the maze procedure for atrial fibrillation associated with atrial septal defect. Korean J Thorac Cardiovasc Surg, 2013, 46(2): 98-103.
14. Soni LK, Cedola SR, Cogan J, et al. Right atrial lesions do not improve the efficacy of a complete left atrial lesion set in the surgical treatment of atrial fibrillation, but they do increase procedural morbidity. J Thorac Cardiovasc Surg, 2013, 145(2): 356-361.
15. Worku B, Pak SW, Cheema F, et al. Incidence and predictors of pacemaker placement after surgical ablation for atrial fibrillation. Ann Thorac Surg, 2011, 92(6): 2085-2089.
16. Gammie JS, Haddad M, Milford-Beland S, et al. Atrial fibrillation correction surgery: lessons from the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg, 2008, 85(3): 909-914.
17. Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation: impact of the maze procedure. Circulation, 2012, 125(17): 2071-2080.
18. Al-Saady NM, Obel OA, Camm AJ. Left atrial appendage: structure, function, and role in thromboembolism. Heart, 1999, 82(5): 547-554.
19. Holmes DR Jr, Doshi SK, Kar S, et al. Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: A patient-level meta-analysis. J Am Coll Cardiol, 2015, 65(24): 2614-2623.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Long-term outcomes of surgical closure of atrial septal defects and concomitant surgical radiofrequency ablation for atrial fibrillation

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