Key result
Orthotopic heart transplantation using a novel technique of approximating the pulmonary vein ostia by gathering sutures successfully reduced left atrial volume from 350 mL to 60 mL.
Why the study?
Does approximation of the pulmonary vein ostia by gathering sutures resolve radical size mismatch during orthotopic heart transplantation in a patient with a giant left atrium?
Case Report (n=1)
Does approximation of the pulmonary vein ostia by gathering sutures resolve radical size mismatch during orthotopic heart transplantation in a patient with a giant left atrium?
Approximation of the pulmonary vein ostia by gathering sutures is a viable surgical technique to resolve radical size mismatch during orthotopic heart transplantation in patients with a giant left atrium.
May address giant left atrium mismatch in transplantation; hypothesis-generating and requires prospective validation before practice change.
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.
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Boldyrev et al. (2014) conducted a case report in Chronic rheumatic heart disease and giant left atrium (n=1). Orthotopic heart transplantation with approximation of pulmonary vein ostia by gathering sutures was evaluated on Left atrial volume. Orthotopic heart transplantation using a novel technique of approximating the pulmonary vein ostia by gathering sutures successfully reduced left atrial volume from 350 mL to 60 mL.
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