Atrial contraction after surgical isolation of the left atrial posterior wall concomitant with mitral valve replacement.
BACKGROUND
Surgical isolation of the left atrial posterior wall (LA-PW isolation) can terminate chronic atrial fibrillation associated with mitral valve disease. However, atrial contraction after LA-PW isolation has not been evaluated.


RESULTS
The study group comprised 14 patients (mean age, 63+/-14 years) with mitral valve disease who recovered and maintained regular sinus rhythm after LA-PW isolation. Before the procedure, and 2-3 weeks and 1 year after the LA-PW isolation, the patients underwent an echocardiographic study. The left atrial (LA) diameter decreased after the LA-PW isolation and the change became significant 1 year later (before: 50.1+/-5.1 mm, after 2-3 weeks: 46.0+/-4.9 mm; p<0.05, after 1 year: 44.0+/-6.1 mm; p<0.05 vs before the operation). The left ventricular (LV) end-diastolic diameter, LV ejection fraction and LV fractional shortening did not change significantly from before the LA-PW isolation and after 1 year. The time - velocity integral of the atrial wave (Ai) and atrial filling fraction significantly increased (Ai: 4.5+/-2.1 cm vs 5.8+/-2.3 cm; p<0.05; atrial filling fraction: 15.4+/-7.7% to 19.2+/-8.3%; p<0.05) during the follow-up period.


CONCLUSIONS
LA-PW isolation can benefit the restoration of regular sinus rhythm and, furthermore, the recovery of atrial contraction.
Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Japan. soutakenaka@yahoo.co.jp
Takenaka
T
Sou
Nakano
N
Yukiko
Shingu
S
Tetsuji
Chayama
C
Kazuaki
Imai
I
Katsuhiko
Sueda
S
Taijiro
D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology; D016279:Atrial Function, Left / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D009200:Myocardial Contraction / Q000502:physiology*