MASSIVE CALCIFICATION OF THE LEFT ATRIUM - SURGICAL IMPLICATIONS

Background. Massive calcification of the atrial walls (''porcelain atr ium'') is a rare condition that usually has been reported as an incide ntal radiologic finding. Methods. Between January 1988 and Tune 1993, 971 patients underwent valvular operation at our institution; 21 patie nts showed extensive calcification of the left atrium. In 8 patients t he calcification was massive, involving almost all the atrial surface. The diagnoses were established by radiology and were confirmed at ope ration. The mean age of these patients (4 men, 4 women) was 55 +/- 9.6 years. All had rheumatic valve disease, were on atrial fibrillation, and had undergone at least one operation previously. Pulmonary artery pressure was severely increased, even up to systemic levels, in all pa tients except 1. Total endoatriectomy of the left atrium and mitral va lve replacement were performed. No patient was lost during the follow- up. Results. Hospital mortality rate was 12.5% (1 patient) and 2 patie nts died in the late postoperative period. None of these deaths are at tributable to the surgical procedure. Conclusions. In tote endoatriect omy of a massively calcified atrium is an easy to perform technique th at helps to replace the mitral valve and close the atrial wall.