loading page

Modified mini-maze via left thoracic cavity under VATS for paroxysmal atrial fibrillation in a patient with complete interruption of the inferior vena cava
  • +2
  • Fan He,
  • Bijun Xu,
  • Shiqiang Wang,
  • Huai-Dong Chen,
  • Weimin Zhang
Fan He
Zhejiang University School of Medicine Sir Run Run Shaw Hospital
Author Profile
Bijun Xu
Zhejiang University School of Medicine Sir Run Run Shaw Hospital
Author Profile
Shiqiang Wang
Zhejiang University School of Medicine Sir Run Run Shaw Hospital
Author Profile
Huai-Dong Chen
Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
Author Profile
Weimin Zhang
Zhejiang University School of Medicine Sir Run Run Shaw Hospital
Author Profile

Abstract

Objectives: We sought to determine the technical feasibility of surgical bipolar radiofrequency ablation (endoscopic maze procedure) through the left chest cavity in patients with an interrupted inferior vena cava (IVC). Methods and Results: A 57-year-old female with paroxysmal atrial fibrillation (AF) and an interrupted IVC was referred to our hospital for radiofrequency ablation. Transseptal puncture and left atrium (LA) ablation failed through a standard IVC approach via the femoral vein due to intrahepatic interruption of IVC. We performed a modified surgical bipolar radiofrequency ablation (RF) on the beating heart through 3 ports in the left chest wall. Pulmonary vein isolation and ablation of the left atrium were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was completed using the ablation pen. The left atrial appendage was excluded. No complications occurred during or after the procedure. The patient was discharged with sinus rhythm 3 days later after the procedure. She was taking amiodarone (100mg bid) within 6 months after the procedure, and had no recurrence of AF. Conclusions: We successfully performed a modified mini-maze procedure in a patient with paroxysmal AF and IVC interruption through the left thoracic cavity under video-assisted thoracoscopic surgery (VATS). We can successfully complete pulmonary vein (PV) isolation, left atrium box isolation, cardiac ganglia ablation, Marshall ligament ablation, and coronary sinus epicardium ablation using this technique.