Tiếp cận cổng so với cắt xương ức để điều trị rung nhĩ do thấp kéo dài kết hợp với phẫu thuật van hai lá

From July 2019 to October 2021, 81 patients with long-standing persistent rheumatic AF underwent biatrial ablation using monopolar radiofrequency devices combined with MV surgery. Patients were divided into two groups: sternotomy group (n=44) and totally endoscopic surgery (TES) group (n=37). Left atrial reduction was performed in all patients. The postoperative and follow-up results were analyzed and compared between the two groups. The mean follow-up times of the sternotomy and the TES groups were 22.2 ± 6.1 months and 20.3 ± 7.7 months, respectively. Results: The perioperative characteristics did not differ between the two groups except that the aortic cross-clamp time and the cardiopulmonary bypass time of the TES group were longer than that of the sternotomy group. One patient in the TES group underwent reoperation. During the follow-up period, one death due to an unknown cause, one stroke for each group, and two patients with prosthetic dysfunction. The rates of atrial rhythm categories at the time of post-operation, discharge, 3-month, 6-month, and 1-year follow-up did not differ between the two groups. At 1-year follow-up, the rates of freedom from AF of the sternotomy group and the TES group were 90.9% and 91.9%, respectively; meanwhile, the rates of sinus rhythm were 86.4% and 86.5%, respectively. Conclusions: AF ablation combined with mitral valve surgery can be performed through port-access as safely and effectively as through the traditional approach.