[Application of extended transseptal approach for a patient with chronic atrial fibrillation caused by mitral stenosis and tricuspid regurgitation].
A 45-year-old female of mitral valvular disease with chronic atrial fibrillation was referred to our hospital. She had received previous closed mitral commissurotomy (12 years ago) and open mitral commissurotomy combined with aortic valve replacement (6 years ago). An echocardiogram showed restenosis and regurgitation of the mitral valve (valve area 1.2 cm2 by B-mode) and severe regurgitation of the tricuspid valve. She also complained of chronic atrial fibrillation since 35 years old. Mitral valve replacement with CarboMedics bileaflet valve (25 mm) and tricuspid annuloplasty by DeVega procedure was undergone via an extended transseptal approach and cryoablastion was added to the posterior wall of the left atrium along the rim of the left pulmonary veins and around the left atrial appendage for ablation of chronic atrial fibrillation. After completion of surgery, atrial fibrillation disappeared. Post operative echocardiogram showed apparent atrial kick of both atriumns in the inflow pattern of both ventricles. The patient continues to be well with normal sinus rhythm for 6 months after surgery. An extended transseptal approach is useful in mitral reoperation, in addition, it can be applicable for the surgery of chronic atrial fibrillation.
First Department of Surgery, Hiroshima University, School of Medicine, Japan.
T
T
Sueda
H
H
Shikata
K
K
Orihashi
N
N
Mitsui
M
M
Sueshiro
Y
Y
Matsuura
D001281:Atrial Fibrillation / Q000209:etiology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002908:Chronic Disease; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000601:surgery; D012086:Reoperation; D014261:Tricuspid Valve / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000601:surgery