[Left atrial isolation for chronic atrial fibrillation associated with valvular disease and coronary artery disease in an 82-year-old man].

An 82-year-old man suffering from chronic atrial fibrillation associated with valvular and coronary artery diseases was admitted to our hospital. Preoperative examination revealed that mitral and aortic valve replacement with tricuspid annuloplasty and coronary artery bypass were required, in addition to surgery for chronic atrial fibrillation. In order to shorten the aortic cross-clamp time and operative time, we performed left atrial isolation, which is a simpler procedure than maze procedure and the left sided maze procedure, because it requires incision of the posterior left atrium only. Since aortic stenosis was severe and the aortic annulus was small, we used a St. Jude Medical Hemodynamic Plus valve as the aortic valve prosthesis, which spares the surgical stress of the aortic annulus. Careful investigation of the patient disorder and selection of optimal surgical procedure makes possible an extended operation of complicated valvular disease even in a high elderly patient over 80 years old.