{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:26:45Z","timestamp":1793622405301,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is a common finding among patients with mitral valve disease, with a growing body of evidence showing survival benefits associated with surgical ablation (SA). However, a lack of data persists regarding the safety and survival after SA concomitant to minimally invasive mitral valve surgery (MIMVS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively collected data from the Polish National Registry of Cardiac Surgery Procedures (Krajowy Rejestr Operacji Kardiochirurgicznych), searching for all adult patients with AF who underwent MIMVS between 2006 and 2021. Initially, 1,545 patients were identified; SA was performed on 512 patients (33.2%). Propensity score matching comparing MIMVS + SA versus MIMVS alone was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Matching resulted in 365 pairs with similar baseline characteristics (median age = 65 years, interquartile range [IQR]: 58 to 70 years; median EuroSCORE II = 2.2%, IQR: 1.4 to 3.4). We observed no differences in 24 h mortality for MIMVS + SA versus MIMVS alone (0.3% vs 0.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.99). Although there was no difference in in-hospital complications, neurologic complications were reported less frequently in the SA group (2.7% vs 8.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). Unadjusted survival analysis favored MIMVS+SA (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.40 to 0.69,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). However, after adjustment for baseline risk factors, the effect was no longer significant (HR = 0.85, 95% CI: 0.56 to 1.32,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.48). When stratified on baseline CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      -VASc score, a gradient of benefit was seen, with patients at higher thromboembolic risk gaining the most benefits from concomitant SA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with a higher thromboembolic risk gain the most benefits from concomitant SA. SA was associated with fewer neurologic complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845261472462","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T07:33:58Z","timestamp":1788766438000},"page":"368-376","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Ablation for Atrial Fibrillation During Minimally Invasive Mitral Valve Surgery: Risk Dependencies and Long-Term Survival"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5478-3245","authenticated-orcid":false,"given":"Mariusz","family":"Kowalewski","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland"},{"name":"Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), The Netherlands"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Maria","family":"Raffa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5329-5856","authenticated-orcid":false,"given":"Jakub","family":"Batko","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"},{"name":"Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"\u015awi\u0119czkowski","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology, Medical University of Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil Julian","family":"D\u0105browski","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology, Medical University of Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1956-7598","authenticated-orcid":false,"given":"Karol","family":"Gostomczyk","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0141ukasz","family":"Ku\u017ama","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"},{"name":"Department of Invasive Cardiology, Medical University of Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Wa\u0144ha","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"},{"name":"Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rados\u0142aw","family":"Litwinowicz","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"},{"name":"Faculty of Medicine, Bydgoszcz University of Science and Technology, Poland"},{"name":"Department of Cardiac Surgery, Wladys\u0142aw Biega\u0144ski Regional Specialist Hospital in Grudzi\u0105dz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Urbanowicz","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland"},{"name":"Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"D\u2019Ascenzo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Turin, Italy"},{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Jasi\u0144ski","sequence":"additional","affiliation":[{"name":"Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazimierz","family":"Widenka","sequence":"additional","affiliation":[{"name":"Clinical Department of Cardiac Surgery, District Hospital No. 2, University of Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2174-1321","authenticated-orcid":false,"given":"Marek","family":"Deja","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland"},{"name":"Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Bartu\u015b","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Hirnle","sequence":"additional","affiliation":[{"name":"Department of Cardiosurgery, Medical University of Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Wojakowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Pilato","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogera","family":"Pisano","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdzis\u0142aw","family":"Tobota","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiothoracic Surgery, The Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohdan J.","family":"Maruszewski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiothoracic Surgery, The Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2670-4164","authenticated-orcid":false,"given":"Piotr","family":"Suwalski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12574-019-00453-w"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.10.076"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.04.035"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1546681"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa232"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.09.038"},{"key":"e_1_3_2_9_2","first-page":"105","article-title":"Illustrated techniques for performing the Cox-Maze IV procedure through a right mini-thoracotomy","volume":"3","author":"Robertson JO","year":"2014","unstructured":"Robertson JO, Saint LL, Leidenfrost JE, et al. Illustrated techniques for performing the Cox-Maze IV procedure through a right mini-thoracotomy. 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