Thoracoscopic resection of the left atrial appendage after failed focal atrial tachycardia ablation

Rachel D. Torok, Benjamin Wei, Ronald J. Kanter, Robert D.B. Jaquiss, Andrew J. Lodge

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background This case series describes 3 patients with the unusual location of focal atrial tachycardia in the left atrial appendage who failed catheter ablation but were successfully treated by left atrial appendage resection by a totally thoracoscopic surgical technique. Methods In all 3 cases, left atrial appendage resection was carried out by video-assisted thoracoscopic surgery using only 3 5- to 10-mm incisions, eliminating the need for median sternotomy or thoracotomy. An endoscopic stapler was used to resect the left atrial appendage at its base, successfully eliminating the source of the patients' focal atrial tachycardia. Results The mean operative time was 84 minutes. All 3 patients tolerated the procedure without any complications and were discharged on postoperative day 3. At an average follow-up of 4.5 years, all patients remained asymptomatic and with normal ambulatory rhythm monitoring off all antiarrhythmic medications. Conclusions Surgical resection of the left atrial appendage using a totally thoracoscopic approach is a safe and successful treatment option for patients who have failed endocardial catheter ablation. This novel approach utilizes smaller incisions and shorter operative times than the more invasive surgical techniques previously described in the literature.

Original languageEnglish (US)
Pages (from-to)1322-1327
Number of pages6
JournalAnnals of Thoracic Surgery
Volume97
Issue number4
DOIs
StatePublished - Jan 1 2014

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Atrial Appendage
Tachycardia
Catheter Ablation
Operative Time
Video-Assisted Thoracic Surgery
Ambulatory Monitoring
Sternotomy
Thoracotomy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Thoracoscopic resection of the left atrial appendage after failed focal atrial tachycardia ablation. / Torok, Rachel D.; Wei, Benjamin; Kanter, Ronald J.; Jaquiss, Robert D.B.; Lodge, Andrew J.

In: Annals of Thoracic Surgery, Vol. 97, No. 4, 01.01.2014, p. 1322-1327.

Research output: Contribution to journalArticle

Torok, Rachel D. ; Wei, Benjamin ; Kanter, Ronald J. ; Jaquiss, Robert D.B. ; Lodge, Andrew J. / Thoracoscopic resection of the left atrial appendage after failed focal atrial tachycardia ablation. In: Annals of Thoracic Surgery. 2014 ; Vol. 97, No. 4. pp. 1322-1327.
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