Left atrial reduction and mitral valve surgery: The "functional-anatomic unit" concept

The desired outcome for patients undergoing mitral valve surgery includes b oth good function of the mitral valve, and preservation and restoration of sinus rhythm. To achieve such an outcome, we evolved the concept of the lef t atrium and mitral valve as a "functional anatomic unit." In this report, we describe a technique for reduction in left atrial size, isolation of the pulmonary veins, and amputation of the left atrial appendage in combinatio n with mitral valve repair, We performed such a procedure in 4 patients, wi th rheumatic mitral valve disease and chronic atrial fibrillation, with res toration of good valve function and sinus rhythm at 16 to 20 months after s urgery. (C) 2001 by The Society of Thoracic Surgeons.