title: Surgical treatment of giant left atrium combined with mitral valvular disease. Plication procedure for reduction of compression to the left ventricle, bronchus, and pulmonary parenchyma.
abstract: Giant left atrium associated with mitral valvular disease frequently produce postoperative problems with regard to hemodynamical and respiratory management. A new procedure of para-annular and superior plication combined with the conventional right-side plication with trimming of the left atrial wall was devised to relieve compression induced by the giant left atrium. A total of 40 patients with giant left atrium underwent operation. Ten had the valvular procedure only and 30 had the valvular and plication procedures. The plication procedure resulted in a significant decrease in the incidence of low-output syndrome and respiratory failure postoperatively, as well as a marked decrease in mortality. We conclude that the plication procedure is an effective means of relieving compression in the presence of giant left atrium.
mesh_terms: D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000209:etiology; D004108:Dilatation, Pathologic / Q000150:complications / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D008943:Mitral Valve; D011183:Postoperative Complications / Q000401:mortality; D012131:Respiratory Insufficiency / Q000209:etiology