Asymptomatic Giant Left Atrium: Do Atrial Size Changes After Successful Valve Replacement? 7-Years Follow-up Case Report
Background: Giant left atrium (GLA) associated with mitral valve surgery reported to have a mortality ranging from 8% to 32%. Most of the patients are symptomatic with that of shortness of breath, dysphagia, palpitations, chest pain, and thromboembolic events. Asymptomatic giant enlargement of the left atrium is rare. Either we must do or not do a reduction arterioplasty at the time of the mitral valve surgery is a controversy in the literature.
Case Report: The patient had mitral valve replacement with a with a 31 mm carbomedics mechanical valve prosthesis 7 years past during her last visit. No reduction arterioplasty was done with a valve operation. Her 7-years close follow-up was uneventful. In the last visit, echocardiography and spiral chest computerized tomography scanning were requested. In both of the requested images giant left trial enlargement was seen, but the patient was without symptoms regarding her giant left atrium.
Conclusions: In this case report, it seems that if we want left atrial size decline, it is necessary to have reduction arterioplasty during mitral valve surgery. However, it does not mean a definite therapeutic efficacy, especially when considering future symptoms.
2. Apostolakis E, Shuhaiber JH. The surgical management of giant left atrium. Eur J Cardiothorac Surg. 2008; 33(2):182-90.
3. Phua GC, Eng PC, Lim SL, Chua YL. Beyond Ortner's syndrome--unusual pulmonary complications of the giant left atrium. Ann Acad Med Singapore. 2005; 34(10): 642-5.
4. Scherer M, Therapidis P, Miskovic A, Moritz A. Left atrial size reduction improves the sinus rhythm conversion rate after radiofrequency ablation for continuous atrial fibrillation in patients undergoing concomitant cardiac surgery. Thorac Cardiovasc Surg. 2006; 54(1): 34-8.
5. Choo SJ, Park NH, Lee SK, Kim JW, Song JK, Song H,et al. Excellent results for atrial fibrillation surgery in the presence of giant left atrium and mitral valve disease. Eur J Cardiothorac Surg. 2004; 26(2): 336-41.
6. Hagihara H, Kitamura S, Kawachi K, Morita R, Taniguchi S, Fukutomi M, et al. Left atrial plication
combined with mitral valve surgery in patients with a giant left atrium. Surg Today. 1995; 25(4): 338-42.
7. Darwazah AK, El Sayed H. Giant left atrium associated with massive thrombus formation. Thromb J. 2013;11(1): 5.
8. Pande S, Agarwal SK, Mohanty S, Bansal A. Effect of mitral valve replacement on reduction of left atrial size. Asian Cardiovasc Thorac Ann. 2013; 21(3): 288
|Issue||Vol 3 No 1-2 (2016)|
|Giant left atrium Atrioplasty Mitral valve disease|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|