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Partial Cardiac Autotransplantation for Reduction of the Left Atrium

Hasan B Erdoan, MD, Kaan Kirali, MD, Suat N Ömerolu, MD, Deniz Göksedef, MD, Ömer Iik, MD, Cevat Yakut, MD

Department of Cardiovascular Surgery, Kouyolu Heart and Research Hospital, Istanbul, Turkey

For reprint information contact: Kaan Kirali, MD Tel: 90 216 326 6969 Fax: 90 216 339 0441 Email: imkkirali{at}yahoo.com Department of Cardiovascular Surgery, Kouyolu Heart and Research Hospital, Kadiköy 81020, Istanbul, Turkey.

Various surgical procedures have been employed to treat a greatly enlarged left atrium. We review the use of partial cardiac autotransplantation to reduce left atrial volume in 7 patients with rheumatic mitral valve disease and left atrial and ventricular volume in 2 patients with idiopathic dilated cardiomyopathy. There were 5 males and 4 females aged 25 to 62 years. The patients with rheumatic etiology had atrial fibrillation, while those with dilated cardiomyopathy had sinus rhythm. The mitral valve was replaced in 6 patients and reconstructed in 3. Mean aortic cross clamp time in the operations involving isolated left atrial resection was 119 ± 44 min. Mean left atrial volume fell from 331 mL to 92 mL, while mean left atrial diameter decreased from 8.6 cm to 4.7 cm. Sinus rhythm was restored in 5 of the 7 patients who had preoperative atrial fibrillation. There was no operative mortality. The patients with dilated cardiomyopathy died in the postoperative period, one on the 14th day from low cardiac output and the other on the 113th day from multiorgan failure. Partial cardiac autotransplantation can be effective in reducing heart chamber size in selected patients, especially those with giant left atrium.

This article has been cited by other articles:

				E. Apostolakis and J. H. Shuhaiber The surgical management of giant left atrium Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 182 - 190. [Abstract] [Full Text] [PDF]