Michael E. DeBakey VA Medical Center - Houston, Texas
Innovative, Minimally Invasive, Video-Assisted Technique Used to Treat Serious Heart Condition
March 14, 2007
The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) is the first hospital in Houston and among the first VA hospitals in the country to use an innovative, minimally invasive, video-assisted surgical technique to treat atrial fibrillation. L to R: Audrius Bredikis, M.D., MEDVAMC Electrophysiology director; Faisal Bakaeen, M.D., MEDVAMC Cardiothoracic staff physician; Joseph Huh, M.D., MEDVAMC Cardiothoracic Surgery chief; and Lucila Balitanas, RN, operating room nurse.
HOUSTON – The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) is the first hospital in Houston and among the first VA hospitals in the country to use an innovative, minimally invasive, video-assisted surgical technique to treat atrial fibrillation (AF). AF is one of the most common heart arrhythmias, affecting millions of patients in the United States alone.
AF is a rapid, irregular heart rhythm commonly causing palpitations and fatigue, and greatly increasing the risk of stroke. Strokes in AF patients are thought to arise from clots in the left atrial appendage. Medical management of AF with medications is usually not effective, requiring patients to consider other more invasive options.
During this new surgical procedure, surgeons remove the atrial appendage, a cul de sac of the left atrium of the heart. This has been found to virtually eliminate the risk of stroke. In addition, abnormal areas in the heart that generate and produce AF are ablated or eliminated to restore regular rhythm.
“Atrial fibrillation can be effectively treated using transvenous ablation or with surgery. This new surgical technique, utilizing a bipolar radiofrequency clamp, has radically changed the way these procedures are performed - making them safer, faster, and more effective,” said Audrius Bredikis, M.D., MEDVAMC Electrophysiology director.
Until recently, the most common surgical approach for treating AF has been to create a series of complex linear "scars" throughout the atria using a ‘cut and saw’ technique during open heart surgery. Called a Maze procedure, the ‘cut and saw’ technique proved to be very effective with more than a 90 percent cure rate, but because of its complexity not widely used. Recent advances in the understanding of AF and the development of new ablation technologies such as radio frequency, cryotherapy, microwave, and ultrasound have enabled surgeons to replace the ‘cut and saw’ technique and perform the Maze procedure rapidly and safely.
“Video-assisted AF ablation is extremely promising because it provides a minimally invasive option to potentially cure a subset of patients who have atrial fibrillation and require anticoagulation. These patients typically have failed or are not suitable candidates for traditional medical treatment,” said Faisal Bakaeen, M.D., MEDVAMC Cardiothoracic staff physician.
“Our team of cardiothoracic surgeons at the Michael E. DeBakey VA Medical Center is excited about the introduction of this cutting-edge procedure. We work closely with cardiologists and cardiac electrophysiologists, and carefully screen our patients to identify those who will benefit from this intervention,” said Joseph Huh, M.D., MEDVAMC chief of Cardiothoracic Surgery.
Atrial fibrillation is easy to diagnose in patients who are having the arrhythmia at the time they visit the doctor. A simple electrocardiogram (ECG) will reveal the diagnosis in virtually all such patients. However, many patients with atrial fibrillation have transient episodes, lasting from minutes to hours. These patients will generally complain of the sudden episodes of palpitations and perhaps shortness of breath. If the episode has ended by the time they receive medical attention, no sign of atrial fibrillation will be found. In these patients, some form of outpatient monitoring is necessary to make a diagnosis.
“We strive to offer our veterans the latest and the best in the field of surgery,” said David Berger, M.D., MEDVAMC Operative Care Line executive. “Our cardiothoracic surgery service handles a high volume of patients and has been recognized for its excellent patient outcomes.”
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