No abstract

The absence of strategies to consistently and effectively address nonparoxysmal atrial fibrillation by nonpharmacological interventions has represented a long-standing treatment gap. A combined epicardial/endocardial ablation strategy, the hybrid Convergent procedure, was developed in response to this clinical need. A subxiphoid incision is used to access the pericardial space facilitating an epicardial ablation directed at isolation of the posterior wall of the left atrium. This is followed by an endocardial ablation to Funding sources: The authors have no funding sources to disclose. Disclosures: Dr Makati serves as a consultant, advisor, and proctor for AtriCure, Boston Scientific, and Medtronic and has received research grants from AtriCure, Boston Scientific, and Medtronic. He serves on speakers bureau for Abbott. Dr Sood serves as a consultant for AtriCure. Dr Lee serves as a consultant for AtriCure. Dr Yang serves as a consultant for AtriCure. Dr Shults serves as a consultant for AtriCure and Medtronic and as a proctor for AtriCure. Dr DeLurgio serves as a consultant for AtriCure, Boston Scientific, and Medtronic and on speakers bureau for AtriCure and Boston Scientific. Dr Gill has received research funding from Abbott and lecture honoraria from AtriCure. Dr Kaba serves as a consultant for AtriCure and Biotronik and on speakers bureau for Daiichi Sankyo and Bayer. Dr Ahsan serves on speakers bureau for AtriCure, Biosense Webster, and Boston Scientific. Dr Lellouche serves as a consultant for Medtronic, Abbott, Boston Scientific, and AtriCure. Dr Blaauw has received department research funding from AtriCure and Medtronic and serves as a proctor for AtriCure, Medtronic, Boston Scientific, and Abbott. Dr Zannis serves as a proctor for AtriCure. Dr Sebag serves as a consultant for AtriCure. Dr Gauri serves as a consultant for Medtronic, IRhythm, and AtriCure. Dr Zembala serves as a proctor for AtriCure and as a consultant for Balton, Abbott, and Boston Scientific.

No abstract

Pulmonary artery involvement has been reported in various degrees of complicated dissection of the ascending aorta. The prognosis remains poor without high-risk surgical intervention, but conservative management can be considered in high-risk cases. We report a case of nonoperative management of an octogenarian who presented with a contained rupture of his proximal ascending aorta, likely from a penetrating atherosclerotic ulcer. It was complicated by extrinsic compression of the pulmonary trunk and transient pulmonary hypertension without features of acute right heart failure. He remained alive at the one-year follow-up.