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Ann Thorac Surg 2001;71:1044-1045
© 2001 The Society of Thoracic Surgeons

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Left atrial reduction and mitral valve surgery: the "functional-anatomic unit" concept

Ovidio A. García-Villarreal, MDa, Humberto Rodríguez, MDa, Alfonso Treviño, MDa, Amadeu B. Gouveia, MDa, Rubén Argüero, MDb

a Department of Cardiothoracic Surgery, Hospital Regional No. 34, Centro Médico Nacional del Norte, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico
b Department of Cardiac Surgery, Hospital de Cardiología, Centro Médico Nacional "Siglo XXI," Instituto Mexicano del Seguro Social, México DF, Mexico

Accepted for publication August 25, 2000.

Address reprint requests to Dr. García-Villarreal, Colón 301 sur, 66350, Santa Catarina, Nuevo León, México
e-mail: abelardog{at}sis.net.mx

The desired outcome for patients undergoing mitral valve surgery includes both good function of the mitral valve, and preservation and restoration of sinus rhythm. To achieve such an outcome, we evolved the concept of the left atrium and mitral valve as a "functional anatomic unit." In this report, we describe a technique for reduction in left atrial size, isolation of the pulmonary veins, and amputation of the left atrial appendage in combina-tion with mitral valve repair. We performed such a procedure in 4 patients, with rheumatic mitral valve disease and chronic atrial fibrillation, with restoration of good valve function and sinus rhythm at 16 to 20 months after surgery.




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