A Case Report:Radial incision approach for chronic atrial fibrillation complicated by cerebral infarction and renal infarction Shohei Yamashina 1 , Junichi Yamazaki 1 , Hirotaka Masabayashi 1 , Shigeo Tanaka 2 , Takashi Nitta 2 , Masahiro Fujii 2 , Yutaka Enomoto 2 1First Department of Internal Medicine, Toho University School to Medicine 2Second Department of Surgery, Nippon Medical School Keyword: 心房細動 , 血栓塞栓症 , 外科的治療 , atrial fibrillation , thromboembolism , surgical treatment pp.1183-1188
Published Date 2000/11/15
DOI https://doi.org/10.11477/mf.1404902197
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A patient with chronic atrial fibrillation experiencedcerebral infarction followed by renal infarction. Weemployed the radial incision approach, a new surgicaltechnique for atrial fibrillation, and succeeded ineliminating the thrombus and fibrillation. The patientwas a 62-year-old female who was diagnosed as havinglone atrial fibrillation, which the patient had neglected.Three months later, the patient was hospitalized forcerebral infarction, from which she recovered followingmedical treatment without any after effects. However,ultrasonography conducted at that time revealed athrombus in the left atrial appendage, so anticoagulanttherapy with Warfarin was initiated. Four months later,the patient was hospitalized again for left renal infarc-tion. While the left kidney had lost all functions, thefunction of the right kidney remained normal and thepatient was conservatively followed up by observation.With respect to atrial fibrillation, the administration ofWarfarin did not prevent recurrence of the embolism. Athrombus was detected again in the left atrial append-age upon re-hospitalization. Surgery was indicated andthe radial incision approach was performed. Theapproach succeeded in eliminating the thrombus andfibrillation. The new approach, compared with the con-ventional Maze method, is a simpler technique andpreserves the atrial contraction capacity postoperatively.The new technique is expected to become a new surgicaltreatment for atrial fibrillation.

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