Meet Inspiring Speakers and Experts at our 3000+ Global Conference Series Events with over 1000+ Conferences, 1000+ Symposiums
and 1000+ Workshops on Medical, Pharma, Engineering, Science, Technology and Business.

Explore and learn more about Conference Series : World's leading Event Organizer

Back

Ovidio A. Garcia-Villarreal

Hospital Zambrano-Hellion, Mexico

Title: Surgical isolation of the pulmonary veins for atrial fibrillation: The reality

Biography

Biography: Ovidio A. Garcia-Villarreal

Abstract

Background: Pulmonary vein (PV) isolation has been the cornerstone in the treatment of atrial fibrillation (AF). Many doubts exist about permanent total disconnection of the PV after catheter-based techniques. Surgical division of the PV is the most convincing technique to avoid any further reconnection. We believe this way is the clearest one to investigate how effective PV isolation alone is in the treatment for atrial fibrillation.

Material & Methods: From 1998 to 2010, we operated on 120 adult patients having rheumatic mitral valve disease and concomitant AF. All of them had long-standing persistent AF (> 1 year of duration). PV isolation was performed surgically by means of cut-and-sew in all these cases of mitral valve surgery. All patients were analyzed at three months, six months, one year, and once yearly after operation. Registers were recorded arising from Holter and echocardiographic study during the follow-up to seven years.

Results: Follow up completed at 93% for seven years. There was only one operative death (0.8%), and seven more along the follow-up. The end point was free from any AF, flutter or atrial tachyarrhythmia. Any type of tachyarrhythmia was present at 39%, 47%, 63%, 68%, and 70% at 3 months, one year, three years, five years, and seven years. The odds ratio for AF recurrence at seven years was 2.33 (95% CI, 1.46-3.71; p < 0.001). Left atrial size > 6.5 cm in diameter was directly related to AF recurrence at seven years after surgery (odds ratio= 8.25 [95% CI, 2.84-24.25; p < 0.001).

Conclusions: By dividing PV surgically, there is no doubt about definitive and complete PV disconnection. Surgical isolation of the PV is not enough to eliminate long-standing persistent AF. More complex procedures such as maze procedure should be considered to treat surgically the AF, especially long-standing persistent AF.