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News and Featured Stories from St. Vincent's Medical Center
Published: 02/10/2009

St. Vincent's Offering New A-FIB Surgery

St Vincent's Medical Center - Bridgeport CTBRIDGEPORT, CT on February 10, 2009— St. Vincent’s Division of Cardiothoracic Surgery is among the first hospitals in Connecticut to perform surgery to correct atrial fibrillation (A Fib), also known as rapid or irregular heartbeat, strictly through the use of endoscopes, or instruments that allow visual inspection of the thorax or chest cavity. The new surgery, called Thoracoscopic Atrial Fibrillation Surgery, is an advancement on the “mini-maze” procedure, which involves scarring of the heart to inhibit the electrical impulses that initiate A Fib.

This new version of mini-maze has the advantage of being performed endoscopically through four tiny, one-cm key-hole incisions in the spaces between the ribs rather than requiring larger incisions and the spreading of the ribs as in the earlier mini-maze. Tiny incisions mean less pain, smaller scars, shorter hospital stay and a quicker return to normal activity.

“The improvement in the postoperative pain has been truly remarkable,” says Rafael Squitieri, MD, Chief of Cardiothoracic Surgery and Interim Chair of Cardiology.

This is a huge step over the original “open-heart cut and sew procedure “ to correct A Fib, and a major advance beyond the more recent approach to “mini-maze. Over this past year, St. Vincent’s cardiothoracic surgeons have perfected the minimally invasive maze procedure and advanced to this totally endoscopic technique. Dr. Squitieri explains how it is done.

“With a tiny camera and video-guided instruments we isolate and neutralize a precise area of tissue around the top of the heart’s atrium,” he said.. “That prevents abnormal electrical impulses from being conducted as A Fib.”

The procedure takes about three hours with a hospital stay of two to three days.

Untreated A Fib is a primary cause of heart attack and stroke. According to Dr. Squitieri, the success rates at St. Vincent’s for the new procedure have been among the highest in the nation.

The surgery offers hope to patients for whom medication has not been effective or who cannot tolerate it, and for those who may not have been helped by earlier procedures.

Individuals who wish to resume activities they once enjoyed may be helped by the new technique. For triathlete David Burn, 50, of New Canaan, his October surgery provided an option that would allow him to maintain his active lifestyle. After having always kept up a rigorous exercise routine, Burn was experiencing unusual fatigue and then the first bout of a racing heart. Once it was determined he was experiencing A Fib, Burn learned his options from Dr. Squitieri.

“I hoped to avoid taking blood thinning medications and as an active guy, also wanted to avoid a defribillator implant, so I opted for the surgery.” The statistician, who was back to work within three months, is now exercising as part of his cardiac rehab and is on his way to achieving his goal of returning to competitive sports. “I couldn’t have had a better doctor or finer care anywhere.”

For more information on the latest minimally invasive surgery to correct A Fib or other cardiac problems, please contact the Division of Cardiothoracic Surgery at St. Vincent’s Medical Center at (203) 576-5788.





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