J.Jpn. Surg. Soc.. 84(1): 31-39, 1983
Original article
GIANT LEFT ATRIUM IN MITRAL VALVE DISEASE: A NEW PLICATION PROCEDURE TO RELEAVE THE COMPRESSIONS OF LEFT VENTRICULAR WALL LEFT BRONCHUS AND RIGHT LUNG
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Department of Cardiovascular Surgery, National Cardiovascular Center, Suita Kohei Kawazoe, Zengi Takahara, Kazuhiko Tanaka, Yoich Ego, Kengi Hayashi, Naobumi Fuji, Yosho Kohara, Yoshtugu Kito, Tsuyoshi Fujita, Hisao Manabe, Shintaro Bepu*) |
We have defined the most serious disorders induced by the presence of giant left atrium in three categories as follows. First, hemodynamic distrubance by the compression of left ventricular wall by downward extension of left atrium (type I), secondly, respiratoryd isturbance yielded by the compression of left main bronchus by upward extension of left atrium (type II), thirdly, compression of right middle lobe by right ward extension of left atrium (type I II). A new procedure of para-annular, superior and right-side plication methods were derived as the procedure to relieve those compressions induced by giant left atrium.
Up to the present, 47 patients with giant left atrium underwent surgery, twelve of valvular procedure only and thrity-five of valvular as wel as plication procedure. The incidence of postoperative low output syndrome and respiratory faiure were evaluated. The plication procedure showed marked decrease in the incidence of low output syndrome and respiratory faiure postoperatively, eventual significant decrease in mortality rate. We conclude that plication procedure is very efective for the treatment of compression in the presence of giant left atrium.
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