Poland's first thoracoscopic hybrid ablation and simultaneous closure of the left atrial appendage

18 apr 2024

The Silesian Centre for Heart Diseases in Zabrze has performed the first hybrid ablation procedure in Poland's first hybrid ablation procedure with access to the heart through the left chest wall chest wall. In addition, during the same procedure in a patient with permanent atrial fibrillation atrial fibrillation, the left atrial appendage was closed, which is the structure of the heart where thrombi responsible for life-threatening or permanent neurological damage to the brain. 

The hybrid ablation procedure is performed in patients with refractory resistant atrial fibrillation. To date, because of the anatomical considerations, cardiac surgeons have previously ablated the inferior wall of the left atrium using a transabdominal approach.  This was a difficult and complicated operation, during which surgeons had to disrupt abdominal and thoracic structures chest. Most of the procedures ended with ablation. Closure of the left atrial appendage closure, which is an effective method of stroke prevention in patients with atrial fibrillation, required another surgical intervention surgical intervention. The team at the Silesian Centre for Heart Diseases in Zabrze managed to perform both procedures in a single operation, using a new surgical access.

- The ablation was performed thoracoscopically (endoscopically) through the left chest wall, without opening the abdominal cavity. At the same time we also performed closure of the left atrial appendage, a procedure that prevents the formation of embolic material that can lead to strokes. The method used is less invasive for the patient; during the operation the risk of violating abdominal organs is minimised," says cardiac surgeon Dr Grzegorz Hirnle, deputy coordinator of the Department of Cardiac Surgery, Heart Transplantation and Mechanical Circulatory Support Unit at the SCCS, who performed the innovative operation. 

The first surgery was attended by a proctor from the Paris-based Institute Mutualiste Montsouris Professor Konstantinos Zannis, who has introduced the new method in several European centres.   

- Patients with persistent atrial fibrillation atrial fibrillation in whom endovascular ablation is not effective. The only limitation to the use of the new method may be respiratory insufficiency patients or high obesity. A patient qualified for the procedure must be respiratory respiratory capacity," adds Dr. Grzegorz Hirnle

At the Silesian Centre for Heart Diseases in Zabrze, further patients have been qualified for surgery using the new The new method has already qualified further patients for surgery.

Author: Marek Mędela, SCCS press officer

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