Russian surgeons perform cardiac autotransplantation to treat giant left atrium, severe mitral and tricuspid regurgitation
Olga Ostrovskaya reports
Arrythmogenic remodelling of the left atrium is a common complication of atrial fibrillation, leading to severe haemodynamic disturbances.
In such cases autotransplantation may be an alternative. Since 1984, a 60-year-old female had severe thyrotoxic craw and persistent atrial fibrillation. Since 2003, she experienced shortness of breath after minimal physical activity and oedema. In December 2005, the patient was admitted for treatment at the Federal Almazov Centre in Saint-Petersburg, with severe congestive heart failure NYHA class IV. Massive combined therapy decreased NYHA class to III. Echocardiograph data revealed severe mitral, tricuspid regurgitation and dilatation of the cardiac chambers: LA – 106x110 mm, LA volume – 810 ml, LVEDD – 69 mm, LVESD – 38 mm, EF – 75%, mitral valve annulus – 50 mm, tricuspid valve annulus - 48 mm. PA pressure was 68 mmHg.
In May 2006, the patient was selected for cardiac autotransplantation surgery. The bypass time was 194 minutes; cross clamp time - 164 minutes. The early postoperative period was stable and without complications.
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