Right Atrial Reduction Plasty: For Cox-maze Procedure

최종범, 김종헌, 김경화, 이정문, 구자홍

전북대학교 의학전문대학원 흉부외과학교실

Background : In patients with a huge right atrium, biatrial Cox-Maze procedure may be ineffective for sinus conversion. We describe a novel technique of right atrial volume reduction that was combined with the Cox-maze procedure in a patient with severe tricuspid regurgitation and huge right atrium, presenting with palpitation, epigastric discomfort and indigestion associated with hepatomegaly, and lower extremity edema.

Methods : Reduction involved simple wide excisions of the redundant atrial wall along the Cox-Maze lesions in the right atrium and an elliptical resection of the redundant septum primum.

Results : Significant reduction of right atrial volume by >50% was achieved, and clinical resolution of tricuspid regurgitation and maintenance of sinus rhythm were seen at > 3-year follow-up.

Conclusion : In patients with atrial fibrillation associated with a huge right atrium, a novel right atrial reduction technique can improve sinus conversion by the Cox-Maze procedure. Without right atrial wall resection in the usual right atrium, the right atrial incision technique may be useful and reliable for right atrial exposure (tricuspid annuloplasty, etc) in patients who need the Cox-Maze procedure.

책임저자: 최종범

전북대학교 의학전문대학원 흉부외과학교실

연락처 : 최종범, Tel: 063-250-1486 , E-mail : jobchoi@jbnu.ac.kr