[Surgical treatment of atrial fibrillation and coronary artery bypass without the use of extracorporeal circulation: case report]. / Tratamiento quirúrgico de fibrilación auricular y bypass aortocoronario sin circulación extracorpórea: caso clínico.

A 71-year-old man presented stable angina due to severe coronariophaty and chronic atrial fibrillation. A radial approach for atrial fibrillation and three coronary artery bypass grafts were performed without cardiopulmonary bypass. The procedure for the arrhythmia ablation was done epicardially with a multipolar radiofrequency catheter. Intraoperatively, the patient regained normal sinus rhythm, with an uneventful postoperative course. Postoperative echocardiography demonstrated the presence of an atrial A wave.

[Partial left atriectomy in the treatment of atrial fibrillation associated with mitral valve disease]. / Auriculectomía parcial izquierda en el tratamiento de la fibrilación auricular por valvulopatía mitral.

BACKGROUND: Atrial fibrillation is frequently observed under conditions associated with atrial dilatation. Atrial size is a factor related to the genesis and maintenance of atrial fibrillation. Predictive parameters of persistence of atrial fibrillation after maze procedure are atrial size and long duration of atrial fibrillation. The aim of this study was to investigate the effects of surgical left atrial reduction in chronic atrial fibrillation by mitral valvulopathy. PATIENTS AND METHOD: nineteen patients with chronic atrial fibrillation and dilated left atrium undergoing mitral valve procedures were included in this prospective study: group I with left atrial reduction (10 patients) and group II including control (9 patients). Both groups were with similar preoperative characteristics. RESULTS: At the mean follow-up of 12 months, all the patients in group II had chronic atrial fibrillation, and 7 patients in group I showed in atrial rhythm (p < 0.003). The patients in whom atrial fibrillation continued after surgery showed left atrial area of 33.8 +/- 12.3 cm2 and a volume of 98.5 +/- 53.9 ml; and the patients with normal rhythm had a left atrial area of 24.5 +/- 5.3 cm2 and a volume 60.3 +/- 21.2 ml. CONCLUSIONS: Preliminary results indicate that surgical left atrial reduction in patients with chronic atrial fibrillation may be a mechanism implicated in the elimination of arrhythmia after surgery.

[Employment of St. Jude "silzone" valve in the surgical treatment of early prosthetic valve endocarditis: a preliminary case report and review of the literature]. / Empleo de la válvula St. Jude "Silzone" en el tratamiento quirúrgico de la endocarditis valvular protésica temprana: caso clínico preliminar y revisión de la bibliografía.

Prosthetic valve endocarditis remains as one of the most life-threatening complication of valve replacement surgery. Homografts are the valve of choice with a lower early risk of endocarditis than other valve substitutes, however they are not always available. Recently a new prosthesis has been introduced with a silver-coated sewing cuff (St. Jude Medical with Silzone coating). Silver is an antimicrobial agent that has been proven to reduce bacterial colonization. We present the case of a 48-year-old man with an early prosthetic valve endocarditis which affected an aortic stentless prosthesis. He was successfully treated with a silver-coated prosthesis. Indications for surgery and the use of this prosthesis as a valuable option in this disease entity are discussed. Although the present patient is an isolated case, the interest of this article is the encouraging result obtained with this new prosthesis for this serious complication. Moreover, the clinical experience is reduced with only a few reports in the literature.