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Maze procedure and cor triatriatum repair
Hiroyuki Nakajima1, Junjiro Kobayashi, Takashi Kurita
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
The Annals of Thoracic Surgery
|July 18, 2002
Summary
Surgical excision of an anomalous septum in cor triatriatum effectively treated severe mitral regurgitation and atrial fibrillation. This procedure restored normal heart function and sinus rhythm in a patient with this rare congenital heart defect.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Cor triatriatum is a rare congenital heart anomaly characterized by an accessory atrial septum dividing the left atrium.
- Lucas-Schmidt type IA involves a complete septum, leading to symptoms like mitral regurgitation and atrial fibrillation.
- This case presents a 39-year-old male with cor triatriatum, severe mitral regurgitation, and atrial fibrillation.
Observation:
- The patient presented with symptoms indicative of significant hemodynamic compromise due to the anomalous septum.
- Surgical intervention included resection of the anomalous septum, mitral valve repair, and the Maze procedure.
- Histological examination revealed fibrotic myocardial tissue within the anomalous septum.
Findings:
- Complete resection of the anomalous septum normalized pulmonary venous drainage to the left ventricle.
- Mitral valve repair successfully addressed the severe mitral regurgitation.
- The Maze procedure and septal excision resulted in the patient regaining sinus rhythm.
Implications:
- Complete surgical excision of the anomalous septum is an effective treatment for cor triatriatum.
- Combined with mitral valve repair and the Maze procedure, it offers a curative solution for associated complications.
- This approach provides a favorable long-term prognosis for patients with cor triatriatum and atrial fibrillation.