[Left atrial plication for left atrium associated with mitral valve disease].
OBJECTIVE
To evaluate the effects of left atrial plication (LAP) in patients with giant left atrium (GLA) associated with mitral valve disease.


METHODS
Twenty-three patients with left atrial diameter (LAD) over 8.0 cm were enrolled. All cases underwent valve replacement and LAP between November 1993 and November 2004 were studied retrospectively. According to New York Heart Association (NYHA) classification, 15 belonged to class III, 8 to class IV. Mitral valve replacements were performed in 18 patients (mechanical valve in 17 and biological valve in 1), double value replacement in 5, tricuspid valve plasty (TVP) in 15, atrial fibrillation radiofrequency ablation in 2.


RESULTS
Low output syndrome happened in 3, respiratory failure in 2. The early death was in 3 cases (operative mortality 13%). The causes of death were: heart failure in 2 cases and stroke in 1. LAD was decreased significantly in patients after operation.


CONCLUSIONS
LAP has considerably beneficial effects on improvement of postoperative respiratory and cardiac function, reducing operative mortality. Atrial fibrillation radiofrequency ablation is effective in patients with GLA associated with valve disease. It may be recommended for patients with GLA during mitral valve surgery, especially for patients with LAD > 8.0 cm.
Zheng
Si-hong
SH
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China. zhengsihong1962@yahoo.com.cn
Sun
Yan-qing
YQ
Meng
Xu
X
Gao
Feng
F
Huang
Fu-hua
FH
D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery; D001705:Bioprosthesis; D006332:Cardiomegaly / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome