A MODIFIED MAZE PROCEDURE PERFORMED ONLY ON THE LEFT ATRIUM FOR CHRONIC ATRIAL-FIBRILLATION ASSOCIATED WITH MITRAL-VALVE DISEASE - REPORT OF A CASE

We describe herein the successful treatment of a patient with chronic atrial fibrillation (AF) associated with mitral valve stenosis and reg urgitation, achieved by performing a modified maze procedure on the le ft atrium alone. The patient was a 51-year-old man who had suffered fr om intractable AF for 17 years, causing multiple cerebral emboli and p alpitations. He had undergone open mitral commissurotomy and balloon c ommissurotomy 15 and 7 years ago, respectively. On admission, an echoc ardiogram revealed mitral valve restenosis and thrombosis in the left atrial appendage. Prosthetic valvular replacement was performed follow ing isolation of all pulmonary veins with cryoablation to the posterio r wall of the left atrium and excision of the left atrial appendage. P ostoperatively, the AF disappeared and echocardiogram demonstrated a l eft atrial kick in the mitral valvular inflow without any evidence of thrombosis in the left atrium. Thus, we believe that our modified ''le ft side only'' maze procedure is a simple and efficient method for the treatment of chronic AF with mitral valve disease.