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Limit of Indication for Plication of Giant Left Atrium

Ece Tonguç, MD, Mert Kestelli, MD, brahim Özsöyler, MD, Levent Yilik, MD, Arif Yilmaz, MD, Cengiz Özbek, MD, Ayhan Akçay, MD, Murat Yeil, MD^1,

Department of Cardiovascular Surgery 1 Department of Cardiology zmir Atatürk Education and Research Hospital zmir, Turkey
For reprint information contact: brahim Özsöyler, MD Tel: 90 232 323 2270 Fax: 90 232 243 4848 email: ibrahimozsoyler{at}yahoo.com Ahmet Hasim Sok. Cilek Apt. No. 8/A D: 2, Narlidere, zmir, Turkey.

Patients with giant left atrium were divided into 2 groups retrospectively. Group 1 comprised 10 patients with compression symptoms who received left atrial plication after mitral valve replacement. Group 2 comprised 31 patients without symptoms of compression who did not mreceive plication. Age, sex, ejection fraction, and left ventricular end-diastolic pressure were similar in the 2 groups preoperatively. Left atrial diameter reduction was not significantly different between the 2 groups. Mean left atrial diameter was 80.41 ± 15.08 mm preoperatively and 66.64 ± 13 mm postoperatively in group 1. In group 2, the mean values were 80 ± 8.95 and 66.1 ± 8.14 mm, respectively. Postoperatively, no differences were observed in ejection fraction or left ventricular end-diastolic pressure between the 2 groups. Left atrial diameter was over 80 mm in 12 patients in group 2 and it did not reduce postoperatively to below 65 mm in 11 of these patients. On the other hand, only 7 of 19 patients with a left atrial diameter below 80 mm preoperatively did not reduce to values below 65 mm (p = 0.04). Therefore, in cases of giant left atrium with a left atrial diameter below 80 mm, plication might not be necessary.

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