[HSF] LA Plication Reduction Plasty

[Nasser F. Abou'Seada]

magnificent photos Prasanna .... 
I don't see much of these LA s that I used to describe can be accommodating
3 bags of 500mls saline or D5/W ..... probably early diagnosis and referral
...!!!

I use almost the same technique .... with some variations .... albeit ....
did not know that the technique is called Kawazoe ....

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of prasannasimha
> Sent: Tuesday, November 21, 2006 9:46 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] LA Plication Reduction Plasty
> 
> Nasser , this is an old picture of a case which required a replacement
> and excision of the LA was also done. I did not excise the LA in the
> case that was discussed but just plicate-imbricated it. I also had
> conserved his native valve.
> Prasanna
> psimha wrote:
> > I use the technique described by Kawazoe which involves interpulmonary
> > vein plication, plication between the pulmonary veins and the mitral
> > annulus and at the roof of the LA. I usually do not do this unless the
> > LA is really huge and papery thin or with an associated cardiovocal
> > syndrome as I have seen that these LA's can and will reduce in size
> > with establishment of sinus rhythm and correction of the mitral
> > disease.. I also at times resected a patch of LA from the inferior end
> > of the atriotomy  extending to the area between the pulmonary veins
> > but after the case with the papery thin LA which bled and was
> > difficult to get hemostasis, I am plicating extensively rather than
> > excising in such LA's - easier and less of a bother. Plication
> > involves both plication and inverting so the exposed internal surface
> > is only one suture line. I think I sent a set of pictures once. In
> > that I had also excised the LA.
> > Some people use a method described by Batista - explant the heart ,
> > trim the LA and auto transplant it back. I am wary of doing such an
> > extensive procedure when an easier alternative exists. People who have
> > done it say that replacement is very easy though I have not heard
> > about a repair being done and tested. On the other hand - how
> > difficult is it to expose the mitral valve in a giant LA - the Giant
> > LA allows the mitral valve to be easily exposed any way.
> > Prasanna
> > Nasser F. Abou'Seada wrote:
> >> Dear Prasanna ...
> >> would you elaborate more on your technique doing left atrial "placation
> >> reduction plasty" ..?
> >>
> >> NFA
> >>
> >>
> >>> -----Original Message-----
> >>> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> >>> bounces at lists.hsforum.com] On Behalf Of prasannasimha
> >>> Sent: Monday, November 20, 2006 12:57 PM
> >>> To: Michael Kuiper
> >>> Cc: OpenHeart-L at lists.hsforum.com; ccm
> >>> Subject: [HSF] Re: ccmlquiz20/11/2006
> >>>
> >>> That was a giant LA in a patient with MR with  Cardiovocal syndrome
> >>> (Ortner's Syndrome)
> >>> This is his X Ray immediately post op after an MVR + Electocautery
Maze
> >>> + Kawazoe procedure (Left atrial plication reduction plasty ) done on
> >>> the 15th.
> >>>
> >>> Prasanna
> >>>
> >>> Michael Kuiper wrote:
> >>>
> >>>> not immediately.... it may be the heart...
> >>>>
> >>>> ----- Original Message ----- From: "prasannasimha"
> >>>> <prasannasimha at gmail.com>
> >>>> To: <OpenHeart-L at lists.hsforum.com>; "ccm" <ccm-l at ccm-l.org>
> >>>> Sent: Monday, November 20, 2006 6:43 PM
> >>>> Subject: ccmlquiz20/11/2006
> >>>>
> >>>>
> >>>>
> >>>>> Will you put a chest tube in this patient ?
> >>>>>
> >>>>> Prasanna
> >>>>>
> >>>>>
> >>>>>
> >>>>>
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> >>>>>
> >>>>>
> >>>>>
> >>
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