Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement
ABSTRACT This case report highlights an innovative surgical approach in orthotopic heart transplantation (OHT) for a patient with the largest recorded giant left atrium, measuring a biplanar volume of 1906 mL. The patient, a 63‐year‐old man with severe heart failure and a history of mitral and aorti...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-08-01
|
| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.70655 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849229083726053376 |
|---|---|
| author | Lorenzo Giovannico Federica Mazzone Giuseppe Fischetti Domenico Parigino Luca Savino Tommaso Acquaviva Aldo Domenico Milano Tomaso Bottio |
| author_facet | Lorenzo Giovannico Federica Mazzone Giuseppe Fischetti Domenico Parigino Luca Savino Tommaso Acquaviva Aldo Domenico Milano Tomaso Bottio |
| author_sort | Lorenzo Giovannico |
| collection | DOAJ |
| description | ABSTRACT This case report highlights an innovative surgical approach in orthotopic heart transplantation (OHT) for a patient with the largest recorded giant left atrium, measuring a biplanar volume of 1906 mL. The patient, a 63‐year‐old man with severe heart failure and a history of mitral and aortic valve replacements, presented with atrial fibrillation, moderate systolic dysfunction, and severe cardiomegaly. Despite optimized medical therapy, his condition warranted heart transplantation. The procedure involved a novel surgical technique utilizing Teflon reinforcement and a bovine pericardial patch to reconstruct the significantly enlarged left atrium. Postoperative outcomes were favorable, with no rejection episodes and resolution of pulmonary symptoms. This report underscores the challenges of atrial size mismatch in OHT and the necessity for tailored surgical strategies to address extreme anatomical variations. The successful outcome exemplifies the potential of customized approaches in complex heart transplant cases. |
| format | Article |
| id | doaj-art-3ab3d16668ed45f6905a3ff30076a32f |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-3ab3d16668ed45f6905a3ff30076a32f2025-08-22T07:33:07ZengWileyClinical Case Reports2050-09042025-08-01138n/an/a10.1002/ccr3.70655Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial EnlargementLorenzo Giovannico0Federica Mazzone1Giuseppe Fischetti2Domenico Parigino3Luca Savino4Tommaso Acquaviva5Aldo Domenico Milano6Tomaso Bottio7Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyCardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe‐J) University of Bari Medical School Bari ItalyABSTRACT This case report highlights an innovative surgical approach in orthotopic heart transplantation (OHT) for a patient with the largest recorded giant left atrium, measuring a biplanar volume of 1906 mL. The patient, a 63‐year‐old man with severe heart failure and a history of mitral and aortic valve replacements, presented with atrial fibrillation, moderate systolic dysfunction, and severe cardiomegaly. Despite optimized medical therapy, his condition warranted heart transplantation. The procedure involved a novel surgical technique utilizing Teflon reinforcement and a bovine pericardial patch to reconstruct the significantly enlarged left atrium. Postoperative outcomes were favorable, with no rejection episodes and resolution of pulmonary symptoms. This report underscores the challenges of atrial size mismatch in OHT and the necessity for tailored surgical strategies to address extreme anatomical variations. The successful outcome exemplifies the potential of customized approaches in complex heart transplant cases.https://doi.org/10.1002/ccr3.70655atrial reconstructionbovine pericardial patchgiant left atriumorthotopic heart transplantationsuperior vena cava syndrome |
| spellingShingle | Lorenzo Giovannico Federica Mazzone Giuseppe Fischetti Domenico Parigino Luca Savino Tommaso Acquaviva Aldo Domenico Milano Tomaso Bottio Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement Clinical Case Reports atrial reconstruction bovine pericardial patch giant left atrium orthotopic heart transplantation superior vena cava syndrome |
| title | Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement |
| title_full | Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement |
| title_fullStr | Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement |
| title_full_unstemmed | Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement |
| title_short | Managing the Giant: A Novel Approach in Orthotopic Heart Transplantation With Extreme Left Atrial Enlargement |
| title_sort | managing the giant a novel approach in orthotopic heart transplantation with extreme left atrial enlargement |
| topic | atrial reconstruction bovine pericardial patch giant left atrium orthotopic heart transplantation superior vena cava syndrome |
| url | https://doi.org/10.1002/ccr3.70655 |
| work_keys_str_mv | AT lorenzogiovannico managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT federicamazzone managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT giuseppefischetti managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT domenicoparigino managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT lucasavino managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT tommasoacquaviva managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT aldodomenicomilano managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement AT tomasobottio managingthegiantanovelapproachinorthotopichearttransplantationwithextremeleftatrialenlargement |