Minimally Invasive Cardiac Surgical Ablation Procedures (MIS)

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Learning about Surgical Treatments for Atrial fibrillation
An educational brochure describing the surgical treatment of atrial fibrillation.
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Tratamiento Quirúrgico de la fibrilación auricular
Un folleto educativo que describe la tratamiento quirúrgico de la fibrilación auricular.
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Researchers estimate that 31% of people with atrial fibrillation have no structural heart damage.69 In these cases, an open heart procedure may not be necessary to surgically ablate the heart, and a minimally invasive cardiac surgical ablation procedure may be an option.

MIS requires three to four small incisions between the ribs on both sides of the chest. The heart is accessed through these incisions, and the lesion set and the left atrial appendage excision or occlusion is performed on the beating heart in a closed chest environment.

Minimally invasive procedures are currently being used in major hospitals and medical facilities around the country. MIS offers many more patients a real opportunity to address their atrial fibrillation without having to undergo open-heart surgery.

 

MIS Success Rates

A 2007 study conducted at the Oregon Heart and Vascular Institute and Oregon Cardiology followed 21 patients with paroxysmal, persistent or long-standing persistent AF. All patients received minimally invasive, closed-chest surgical ablation of the pulmonary veins and ganglionated plexi, elimination of the ligament of Marshall, and exclusion of the left atrial appendage. Patient follow-up included 30-day continuous monitoring with a device capable of detecting asymptomatic arrhythmias. Success was defined as freedom from AF and left atrial arrhythmias and freedom from antiarrhythmic drugs. After one year, 87.5% of combined paroxysmal and persistent patients were free from atrial fibrillation and the need to take antiarrhythmic drugs. The study’s overall success rate, regardless of classification of atrial fibrillation, was 75%.83

MIS Risks

Because MIS is a closed-chest procedure, the surgery tends to last only a few hours. Recovery is generally short, with a hospital stay of approximately 2 to 4 days.70 However, as with any surgical procedure, there are risks involved. 

Common MIS Risks

• Bleeding associated with tissue dissection and left atrial appendage removal
• Collapsed lung (correctable with a chest tube)
• Phlebitis - vein inflammation
• Pericarditis - heart tissue inflammation
• Phrenic nerve damage
• Blood vessel damage
• Heart damage

Please check with your doctor for additional risks. Your doctor can help you understand how your overall health and age affect these risks.

Participate in a MIS Clinical Trial

Your doctor can help you decide what your treatment options are based upon the type of atrial fibrillation you have and your overall health and medical history. Take the time to educate yourself about your treatment options, write down questions to ask your doctor at your next follow-up, and speak to your physician about your options and concerns. If you are a patient or physician and are interested in learning additional information about clinical studies currently underway, please visit clinicaltrials.gov.