左心耳アプローチによる外科的左房アブレーション

Surgical Left Atrial Ablation Through the Left Atrial Appendage During Aortic Valve Replacement

大動脈弁置換術（AVR）と同時に，心房細動（AF）に対し経左心耳（LAA）的に左房の外科的アブレーション（SAB）を2例に施行し，術後5年以上，洞調律（SR）を維持しえたので報告する．

This is a 2-case report of concomitant left atrial （LA） surgical ablation through the left atrial appendage （LAA） for atrial fibrillation （AF） during aortic valve replacement （AVR）. Case 1, a 74-year-old man, and Case 2, an 85-years-old woman, were presented for AVR and AF. Under the cardio-pulmonary bypass, right and left pulmonary vein isolations （PVIs） were performed with radiofrequency （RF） ablation devices. Through the opened LAA, an RF lesion was placed to connect the bilateral PVIs and the LAA, and another RF line was placed toward the mitral annulus. A right atrial （RA） isthmus ablation was also performed through a RA incision. Postoperatively, sinus rhythm and both RA and LA contraction were obtained, and have been maintained for 7.5 and 5 years without classⅠ/Ⅲ antiarrhythmic drugs in Case 1 and 2, respectively. This procedure is considered to be effective and safe, although further study is needed.