Key result
Left atrial triangular plasty during mitral correction linked to ~34% lower mortality and improved morphometry.
Why the study?
The study evaluated the feasibility and effects of left atrium triangular plasty during correction of mitral failure combined with left atriomegaly.
Does triangular plasty of the left atrium improve echocardiographic indices and reduce lethality in patients undergoing correction of mitral failure with left atriomegaly?
Cohort (n=330)
No
Does triangular plasty of the left atrium improve echocardiographic indices and reduce lethality in patients undergoing correction of mitral failure with left atriomegaly?
Triangular plasty of the left atrium during mitral valve surgery effectively reduces left atrial size and improves left ventricular morphometry without increasing operative mortality.
May support adjunctive triangular plasty in mitral surgery with atriomegaly; leaves open need for randomized confirmation.
Objective. Studying of possibilities of procedure of the left atrium triangular plasty while doing correction of mitral failure, coexisted with left atriomegaly. Materials and methods. There were analyzed results of surgical treatment of 330 patients, suffering mitral failure in combination with left atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery in period from 1 Jan 2005 to 1 Jan 2021 yr. The main group have consisted of 143 patients, to whom correction of mitral failure together with original procedure of triangular plasty of left atrium was performed. The control group have consisted of 187 patients, to whom correction of mitral failure was done only, although they suffered concurrent left atriomegaly. Results. Of 143 patients operated in the main group 3 died (lethality have constituted 2.1%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (69.1 ± 12.1) ml/m2 before the operation, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the left ventricle ejection fraction – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively 0.56 ± 0.04 in late period. The left atrium diameter dynamics was following: (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, and (53.5 ± 2.2) mm in late period. Of 187 оperated patients of control group 6 have died, (lethality have constituted 3.2%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (68.3 ± 11.3) ml/m2 before the operation, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the left ventricle ejection fraction – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of left atrium: (66.5 ± 3.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in late period. Conclusion. Triangular plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement in its morphometry and accompanied by low risk of hospital lethality.
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Попов et al. (2021) conducted a cohort in Mitral failure with left atriomegaly (n=330). Triangular plasty of left atrium with mitral failure correction vs. Correction of mitral failure only was evaluated on Lethality. Triangular plasty of the left atrium during mitral failure correction was associated with 2.1% lethality versus 3.2% for mitral correction alone, alongside improved left atrial morphometry.
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