RESILIA tissue expected to prevent structural valve deterioration owing to calcification on leaflets was firstly mounted in a mitral bioprosthesis, named MITRIS RESILIA mitral valve (MITRIS). MITRIS has softer cuff than Magna Mitral Ease and stent posts that deflect to prevent suture looping. A 77-year-old man, having a history of long-standing atrial fibrillation, presented with dyspnea on effort. An echocardiography suggested atrial functional MR. We successfully replaced mitral valve using a 27-mm MITRIS, and his postoperative course was uneventful with good hemodynamics. MITRIS may have advantages for implantability and durability, making it a promising prosthesis for patients requiring mitral surgery.

Primary cardiac lymphoma is rare, with a frequency of 1.0% to 1.6% among cardiac malignant tumors. Chemotherapy is often selected as first-line treatment for primary cardiac lymphoma. However, when the tumor causes heart failure or life-threatening hemodynamic collapse, antecedent urgent surgery is required. We herein report a successful case of complete tumor resection and reconstruction of the right atrium and right ventricle using a bovine pericardial patch combined with tricuspid valve replacement in a patient with a huge primary cardiac lymphoma filling the right heart that manifested as tricuspid valve stenosis and subsequent heart failure.

Introduction: There are few reports of the characteristics, mechanisms, and outcomes of atrial tachycardia (AT) and atrial fibrillation (AF) ablation after cardiac surgery and concomitant Maze procedures. This study investigated the mechanisms and long-term outcomes of AT and AF ablation after various Maze procedures, especially we examined in detail whether the arrhythmia after Maze procedure was due to gap or not. Methods and Results: We analyzed 37 consecutive cases with AT and AF after cardiac surgery and Maze procedure between 2007 and 2019. Fifty-nine atrial arrythmias were induced in 37 consecutive cases, and 49 of those atrial arrythmias were mappable ATs. Forty-two ATs was related to the Maze procedure in the 49 mappable ATs (87.5%). All 37 consecutive cases had residual electrical conductions (gaps) in the Maze lines (88 gaps; 2.4±1.2 gaps/patient). Forty-two of 88 gaps (47.7%) were associated with gap-related ATs. The most common gap-related ATs in this study were peri-mitral atrial flutter in 22 cases. The median follow-up period after ablation was 3.6±3.2 years (median, 2.1 years; interquartile range, 0.89-6.84). The Kaplan-Meier analysis of freedom from recurrent atrial arrhythmia after Maze procedure was 79.9% at 1-year follow up and 69.3% at 4-year follow up. Conclusions: Reentry was the main mechanism of AT after cardiac surgery and concomitant various Maze procedures, and AT were largely related to the gap in the Maze line between mitral valve anulus and pulmonary vein isolation line. Catheter ablation of AT after various Maze procedures seemed to be effective and safe during long-term follow-up.