Subject(s)
Cardiac Surgical Procedures/methods , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Fundoplication/adverse effects , Gastroesophageal Reflux/surgery , Hernia, Hiatal/surgery , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Cardiac Tamponade/diagnostic imaging , Coronary Angiography/methods , Electrocardiography/methods , Emergency Service, Hospital , Follow-Up Studies , Fundoplication/methods , Gastroesophageal Reflux/diagnosis , Hernia, Hiatal/complications , Humans , Male , Middle Aged , Pericardium/surgery , Recurrence , Sternotomy/methods , Surgical Flaps/transplantation , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
AIM: Surgical ablation for atrial fibrillation has been performed at Wellington hospital for 10 years. This audit aims to evaluate the outcomes from surgical intervention for atrial fibrillation and identify variables affecting clinical results. METHOD: A retrospective audit of clinical outcomes was performed including all patients who had received surgical intervention for atrial fibrillation from 2004 to 2013. RESULTS: Forty-seven patients who underwent surgical intervention for atrial fibrillation were identified and reviewed. There were no deaths prior to discharge. At 6 months, 81.4% of patients were in sinus rhythm, this dropped to 58.7% at late follow-up (average of 48 months). Procedure type had a statistically significant effect on outcome. Over 288 patient-years of follow-up, 2 strokes and 7 deaths occurred. CONCLUSIONS: The surgical treatment of atrial arrhythmias in Wellington hospital is a safe and effective management option, although the antiarrhythmic effects do appear to diminish with time. There were lower rates of mortality and stroke long-term than would be expected with simple anticoagulation. It is important that the formal Cox-Maze procedure lesion set is performed to maximise the surgical interventions effectiveness. Atrial size predicts success, and should be considered in patient selection.
