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Date Published: 24/10/2025
Abstract Views: 23
Views PDF: 12
DOI: 10.47972/vjcts.v53i.1550
Issue
Vol. 53
Section
Research Article
How to Cite
Dao, T. D., Nguyen, C. H., & Dam, H. S. (2025). Outcomes of 3D Endoscopic Mitral Valve Replacement Combined with Radiofrequency Ablation for Atrial Fibrillation. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 53, 104 - 113. https://doi.org/10.47972/vjcts.v53i.1550

Outcomes of 3D Endoscopic Mitral Valve Replacement Combined with Radiofrequency Ablation for Atrial Fibrillation

Tien Dat Dao1, Cong Huu Nguyen2, Hai Son Dam2,
1 Hanoi Medical University
2 E Hospital

Main Article Content

Abstract

Introduction: Concomitant management of atrial fibrillation during mitral valve surgery is traditionally performed via median sternotomy. Minimally invasive endoscopic approaches are increasingly adopted because of several advantages. This study evaluates outcomes of radiofrequency atrial fibrillation ablation performed concomitantly with minimally invasive endoscopic mitral valve surgery using a 3-D camera system.
Methods: Retrospective descriptive study; 34 patients underwent totally endoscopic 3D mitral valve replacement ± tricuspid valve surgery combined with atrial fibrillation ablation using a unipolar radiofrequency probe following the Cox-Maze IV lesion set, from January 2020 to December 2023 at the Cardiovascular Center, E Hospital.


Results: In 34 patients, 26 were female (76.5%) and 8 were male (23.5%), with a mean age of 55.9 ± 7.2 years (range 46–73).. Left atrial diameter decreased from 55.1 ± 5.8 mm to 43.3 ± 6.3 mm, ejection fraction improved from 58.8 ± 5.6% to 63.1 ± 8.6%, and pulmonary artery pressure decreased from 39.6 ± 8.9 mmHg to 33.3 ± 4.4 mmHg. Sinus rhythm was restored in 64,7% immediately after surgery and 79,4% at discharge. No cases required conversion to sternotomy. One patient required reoperation for bleeding. The 3D endoscopic technique improved surgical precision and enhanced recovery.


Conclusions: Totally endoscopic 3D MVR combined with RF ablation for AF is safe and effective, achieving high rates of sinus rhythm restoration, improved hemodynamic parameters, and favorable early outcomes. This technique should be considered in experienced centers and warrants multicenter studies with long-term follow-up.

Keywords

mitral valve replacement, atrial fibrillation, Cox-MAZE IV, 3D endoscopy

Article Details

References

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