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FFF Fellowships Building visibility of Atrial Fibrillation
Increasing visibility and building knowledge of Atrial Fibrillation
The Atrial Fibrillation Fellowship is designed to enhance clinical understanding and surgical proficiency in treating patients with atrial fibrillation (AF). The Fellowship supports cardiothoracic surgeons working towards a leadership role in surgical AF treatment.
Dr Manuel Castella
Dr Manuel Castella is a cardiovascular surgeon and Chief of the cardiovascular surgery department at Hospital Clinic, University of Barcelona, Spain. In his role as project lead of the Francis Fontan Fund Atrial Fibrillation Fellowship he describes how the Fellowship has grown to support more Fellows to develop the skills and knowledge to treat Atrial Fibrillation. Atrial Fibrillation was previously considered a minor problem in patients submitted for cardiac surgery despite the fact it can lead to complications such as heart failure and strokes. But scientific evidence urges surgeons to treat AF both by ablation and by left appendage closure. Additionally, new surgical opportunities arise in patients with isolated AF, in the form of thoracoscopic ablation or even hybrid therapies combining surgery with catheter ablation. We surgeons have the most effective tools to treat this
Yuriy Mandryk
Yuriy Mandryk, Registrar in Cardiac Surgery, HKZ Bad Bevensen, Germany. The focus of my training was the management of Atrial Fibrillation (AF). This kind of surgery is uncommon in daily practice and therefore it is difficult to gain the experience in this field. During my placement I worked at MSWiA Hospital in Warsaw, a high-volume centre with experts in the field of Atrial Fibrillation. I was able to gain hands on experience in the key options of the surgical ablation, such as minimal invasive MAZE IV procedure via lateral thoracotomy, bilateral thoracoscopic MAZE III procedure and left atrial appendage (LAA) clipping in patients with lone refractory AF. Most importantly, I learnt valuable tips and tricks about how to avoid complications which help to accelerate the learning curve. I am confident that the learning and knowledge gained from this Fellowship will be useful in my daily practice, with plans to establish our own AF surgery program in cooperation with electrophysiologists. I would strongly encourage young surgeons to apply for this Fellowship, because it not only provides the important theoretical understanding of underlying pathophysiology of Atrial Fibrillation, but also gives valuable hands-on experience. I would like to express my great gratitude to hosting Professor Piotr Suwalski and the team of cardiac surgery of MSWiA Hospital in Warsaw.
disease, but we need to increase visibility and build knowledge across the cardiovascular community. The Atrial Fibrillation Fellowship is a great step to achieve this, giving Fellows the opportunity to work with experts in Atrial Fibrillation and taking learning back to their home centres. Thanks to the financial support of our sponsor Atricure, we have increased the number of Atrial Fibrillation Fellowships available, with eight Fellows selected each year. I am also delighted that we now have five centres actively participating in the Fellowship. Europe has the most experienced centres in Atrial Fibrillation in the world with some of the top researchers and surgeons in the field. To have their support and involvement in the Fellowship is very welcome. It is important that Fellows are able to get the most out of this amazing opportunity. We always try to pair Fellows with a centre that is most suitable for both their specific interests and level of knowledge. Additionally, we need to look beyond Europe to give Fellowship opportunities to other EACTS members based in Latin America and Africa. This will help to widen the knowledge and expertise around Atrial Fibrillation across the global cardiothoracic community. Four fellows discuss how the Atrial Fibrillation Fellowship has provided a fantastic opportunity to gain first-hand experience of Atrial Fibrillation surgical procedures from experts in the field and how they will use this experience to improve patient outcomes in their home centres.
Mohamed Elsaegh Rui Cerejo
Mohamed Elsaegh, Post CCT Fellow Cardiothoracic Surgery, Bristol Heart Institute, Bristol. Taking part in the Atrial Fibrillation Fellowship was a very positive experience which will undoubtedly benefit my career now and in the future. The opportunity to work with and receive one-to-one coaching from world-class surgeon, Mr Steven Hunter, has been invaluable. The Northern General Hospital in Sheffield is an established centre for Atrial Fibrillation (AF) surgery and, as part of my placement, I was involved in all aspects of patient care - from pre-operative assessments to following up with patients postsurgery to assess the success of their procedure. Working as part of the surgical team I was fortunate to learn new surgical techniques as well as new and innovative approaches. Many centres do not undertake Atrial Fibrillation surgical procedures. The impact of AF is often not fully appreciated but if left untreated Atrial Fibrillation can have a significant impact on a patient’s long-term outcome. Without this fellowship I would not have had the opportunity to gain first-hand experience of treating this condition, which I am confident will benefit my patients. As such, I am now sharing the knowledge that I have gained from this Fellowship with my colleagues, for example, teaching the indications of AF and the necessary surgical steps. I plan to use the experience to set up an AF programme in the future, with the support of Professor Hunter. Rui Cerejo, Cardiac Surgeon, Hospital de Santa Marta - Centro Hospitalar Universitário Lisboa Central, Lisbon (Portugal) The Atrial Fibrillation Fellowship has truly changed the way I see and practice heart surgery. I have acquired knowledge that allows me to have new notions of indications for AF ablation and new surgical techniques to achieve the goals I set for myself and my patients. Thanks to this Fellowship, I have already participated in a very interesting AF surgical ablation course, including cadaver training, which was an important part of my learning. However, the opportunity to visit and learn in a centre of high differentiation and volume in Germany for around four weeks with the chance to witness and learn from some great personalities of European Heart Surgery has been invaluable. Such an experience enhances your skills and competences and can make a real difference to the way you will carry out your clinical practice. For example, I was able to learn tricks for an effective and successful ablation as well as refining and developing new skills in other areas of cardiac surgery, such as minimally invasive surgery. I am confident that the knowledge that I have acquired as part of this Fellowship will increase my centre’s experience in treating Atrial Fibrillation. The ability to perform different procedures will help to increase the spectrum of patients who can be treated and undoubtedly improve overall outcomes.
Mikhail Snegirev
Mikhail Snegirev, a cardiac surgeon from City Hospital No 40, St Petersburg Taking part in the Atrial Fibrillation Fellowship was a very exciting experience. I already carried out a lot of minimally invasive atrial fibrillation operations in my home institution but St Antonius hospital in the Netherlands takes a more significantly advanced approach. This gave me the opportunity to observe different surgical options including the ultimate minimally invasive strategy – the single side mini MAZE approach, which is uncommon in my country. Professor Van Putte is one of the leaders in Europe of this approach, so it was a genuine pleasure to watch and learn from him. Moreover, I learnt how to overcome technical problems in standard and port-access MAZE operations and how to improve the overall flow of the concomitant cases. I also learnt other invaluable skills such as how to select patients and how to communicate effectively with other departments within a hospital and the organisation of such a multidisciplinary practice. There is no doubt this Fellowship will help to further establish my career. I am looking forward to continuing to build my relationship with Professor Van Putte as I explore the potential to introduce single side minimally invasive Atrial Fibrillation to my home institution.
