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Massive calcification of the left atrium: surgical implications
J L Vallejo1, C Merino, J M González-Santos
1Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
The Annals of Thoracic Surgery
|November 1, 1995
Summary
Massive calcification of the left atrium, known as porcelain atrium, can be surgically managed. Total endoatriectomy and mitral valve replacement is a feasible technique for this rare condition.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
Background:
- Porcelain atrium, characterized by massive atrial wall calcification, is a rare incidental finding.
- This condition often presents in patients with a history of rheumatic valve disease and atrial fibrillation.
Purpose of the Study:
- To evaluate the feasibility and outcomes of total endoatriectomy and mitral valve replacement in patients with massive left atrial calcification.
Main Methods:
- A retrospective review of 21 patients with extensive left atrial calcification undergoing valvular operation between 1988 and 1993.
- Eight patients had massive calcification requiring total endoatriectomy and mitral valve replacement.
- Surgical diagnoses were confirmed radiologically and intraoperatively.
Main Results:
- The study included 8 patients (4 men, 4 women) with a mean age of 55 years.
- All patients had rheumatic valve disease, atrial fibrillation, and prior operations.
- Hospital mortality was 12.5% (1 patient), with 2 late deaths not attributed to the procedure.
Conclusions:
- Total endoatriectomy of a massively calcified left atrium is a technically straightforward procedure.
- This technique facilitates mitral valve replacement and closure of the atrial wall.