[Transatrial approach to provide exposure of the left atrium]

Surgical exposure of the left atrial structures including the mitral valve apparatus is occasionally problematic, when the left atrium is small or noncompliant in the presence of previously implanted aortic prosthesis. We operated eleven cases with an incision that is a modification of a maneuver proposed by Dubost and colleagues, and all but one provide an excellent exposure of the left atrium and mitral valve apparatus. In one case of combined valvular disease complicated by chronic pericarditis, operative view was not satisfactory. The preserves equine pericardial patch was utilized to close the incision in 5 cases. No serious arrhythmias as atrioventricular conduction block was experienced. With this maneuver, the application is recommended to provide excellent exposure into the left atrium and mitral valve apparatus.