Long-standing persistent effects of atrial volume reduction combined with pulmonary vein isolation

Publication date: Available online 18 June 2018 Source:Journal of Cardiology Cases Author(s): Masami Takagaki, Naoko Ikeda, Hiroki Yamaguchi, Shinichi Mitsuyama, Tasuku Kadowaki, Tatsuya Nakao Although surgical left atrial (LA) volume reduction combined with mitral valve surgery and/or surgical ablation for atrial fibrillation has been reported to be effective, its long-term outcomes in the absence of mitral procedure are not well established. A 74-year-old man with two previous sternotomies—the first for pericardiectomy due to constrictive pericarditis and the second for mitral valve replacement with mechanical valve and tricuspid annuloplasty—presented with heart failure and thrombus in his giant left atrium (1291mL), complicated by cerebral infarction. His electrocardiogram showed rate-controlled persistent atrial fibrillation. His mechanical valve was functioning well. A third atrial volume reduction combined with pulmonary vein isolation, without valve surgery, was performed. The postoperative course was uneventful, and the patient has remained asymptomatic with regular junctional rhythm and without any episodes of thromboembolism or re-dilation of LA (approximately 550mL). His left ventricular filling improved with end-diastolic volume (96mL vs 140mL) and forced vital capacity (2.60L vs 2.89L) increased. Both remained relatively constant for 6 years. The combination of atrial volume reduction with pulmonary vein isolation prevented thromboembolism, improved ...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research