title: A patient with giant left atrium undergoes orthotopic heart transplantation.
abstract: We present a novel technique for resolving the problem of radical size mismatch at the time of orthotopic transplantation. A 48-year-old man presented with chronic rheumatic heart disease and a giant left atrium. Twenty-three years before, he had undergone mitral valve replacement with a mechanical prosthesis. At the time of the repeated intervention, the volume of his left atrium was 350 mL. Surgical features of the transplantation included approximation of the pulmonary vein ostia by gathering sutures intentionally, in order to decrease the area of the left atrial posterior wall and thereby enable appropriate coaptation with the donor left atrium. After the operation, left atrial volume had been reduced to 60 mL.
authors: Department of Adult Cardiac Surgery (Drs. Barbukhatty, Boldyrev, Lepshokov, Porhanov, and Yakuba), Regional Clinic Hospital #1; and Cardiac Surgery and Cardiology Department (Dr. Barbukhatty), Kuban State Medical University; 350086 Krasnodar, Russia.
authors: Sergey Y
authors: SY
authors: Boldyrev
authors: Murat K
authors: MK
authors: Lepshokov
authors: Igor I
authors: II
authors: Yakuba
authors: Kirill O
authors: KO
authors: Barbukhatty
authors: Vladimir A
authors: VA
authors: Porhanov
mesh_terms: D006332:Cardiomegaly / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D016027:Heart Transplantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D012214:Rheumatic Heart Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome