Right atrial reduction plasty associated with the cox-maze procedure

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology
• Thoracic Surgery

Background:

• Giant right atrium presents surgical challenges, often associated with permanent atrial fibrillation.
• The Cox-maze procedure is a standard treatment for atrial fibrillation but may be less effective in significantly enlarged atria.

Observation:

• A patient with a giant right atrium and permanent atrial fibrillation underwent a combined surgical procedure.
• The surgery involved right atrial reduction plasty and the Cox-maze procedure, including atrial wall and septum excision.

Findings:

• The combined procedure resulted in a 60% reduction in atrial dimension and an 80% reduction in atrial volume.
• Successful maintenance of sinus rhythm and reduced atrial size was observed at a 3.5-year follow-up.

Implications:

• This surgical technique offers a potentially effective solution for managing giant right atrium with concomitant atrial fibrillation.
• Further studies are warranted to evaluate the long-term efficacy and applicability of this combined approach in a larger patient cohort.