title: Initial experience with Pomerantzeff's technique for reduction of the size of giant left atrium.
abstract: BACKGROUND
  The most common indication for surgical correction of giant left atrium is associated with mitral valve insufficiency with or without atrial fibrillation. Several techniques for this purpose are already described with varying results.
  
  
  OBJECTIVE
  To present the initial experience with the tangential triangular resection technique (Pomerantzeff).
  
  
  METHODS
  From 2002 to 2010, four patients underwent mitral valve operation with reduction of left atrial volume by the technique of triangular resection tangential in our service. Three patients were female. The age ranged from 21 to 51 years old. The four patients presented with atrial fibrillation. Ejection fraction of left ventricle preoperatively ranged from 38% to 62%. The left atrial diameter ranged from 78mm to 140mm. After treatment of mitral dysfunction, the left atrium was reduced by resecting triangular tangential posterior wall between the pulmonary veins to avoid anatomic distortion of the mitral valve or pulmonary veins, reducing tension in the suture line.
  
  
  RESULTS
  Average hospital stay was 21.5 ± 6.5 days. The mean cardiopulmonary bypass time was 130 ± 30 minutes. There was no surgical bleeding or mortality in the postoperative period. All patients had sinus rhythm restored in the output of cardiopulmonary bypass, maintaining this rate postoperatively. The average diameter of the left atrium was reduced by 50.5% ± 19.5%. The left ventricular ejection fraction improved in all patients.
  
  
  CONCLUSIONS
  Initial results with this technique have shown effective reduction of the left atrium.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. jocerlanosousa@hotmail.com
authors.forename: Jocerlano Santos de
authors.initials: JS
authors.lastname: Sousa
authors.forename: Pablo Maria Alberto
authors.initials: PM
authors.lastname: Pomerantzeff
authors.forename: Carlos Manuel de Almeida
authors.initials: CM
authors.lastname: Brandão
authors.forename: Lisandro Azeredo
authors.initials: LA
authors.lastname: Gonçalves
authors.forename: Marcos Gradim
authors.initials: MG
authors.lastname: Tiveron
authors.forename: Marcelo Luiz Campos
authors.initials: ML
authors.lastname: Vieira
authors.forename: Flavio
authors.initials: F
authors.lastname: Tarasoutchi
authors.forename: Noedir Antônio Groppo
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D000328:Adult; D006332:Cardiomegaly / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D061646:Operative Time; D009929:Organ Size; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome