First live training session of mini-maze heart surgery broadcast to largest meeting of electrophysiologists
Thursday, Jan. 24, 2008
A group of Virginia
Commonwealth University cardiothoracic surgeons conducted a training
session of a procedure to help stop irregular heart rhythm that was
transmitted live from an operating room at VCU’s Pauley Heart Center to
a large audience of electrophysiologists gathered at the 13th Annual
International Boston Atrial Fibrillation Symposium in Massachusetts on
Atrial fibrillation, or a-fib, is an irregular rhythm
that affects more than 2 million Americans, interfering with the
heart’s ability to efficiently pump blood. As a result, blood can pool
in the atria, which can lead to the formation of clots and the
possibility of a stroke. It is caused by abnormal electrical impulses
that begin at the top of the heart and travel down the upper chambers,
or atria, causing them to contract erratically.
The VCU team, led by Vigneshwar Kasirajan, M.D., chair of cardiothoracic surgery, and Kenneth Ellenbogen, M.D.,
professor of cardiology and director of the cardiac electrophysiology
lab, used a minimally invasive technique, called a modified Mini-Maze.
This approach allows surgeons to block the abnormal impulse from
getting to the heart to trigger the a-fib. Ellenbogen narrated the
procedure as it took place and used several slides to further
illustrate the case.
“The opportunity to educate the wider
electrophysiology community about the benefits of surgical therapy for
atrial fibrillation was tremendous and well received. The satellite
transmission was of excellent quality and clearly demonstrated the
process,” Kasirajan said.
During the procedure, surgeons insert
instruments into the chest through several keyhole-size incisions
between the ribs. With the aid of a tiny video camera, a specially
designed instrument is placed around the pulmonary veins and atria, and
energy is delivered to destroy the tissue near the origin of the
irregular impulses. The damaged tissue disrupts the abnormal signaling
pathways, stopping the irregular impulses.
catheter ablation, which treats the inside of the heart, the Mini-Maze
technique is performed on the heart’s surface, “which also allows us to
map the nerve endings, or autonomic ganglia, in these areas that may be
the source of atrial fibrillation, and remove the left atrial appendage
where blood clots may form,” according to Kasirajan.
The team at VCU used cardiac ablation technology from AtriCure Inc.