What does this research mean for the field?

While surgical reduction of an extreme giant left atrium in rheumatic mitral valve disease is technically feasible, careful patient selection and preoperative optimization are crucial due to high mortality risks in patients with advanced right heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the surgical approach, clinical challenges, and postoperative outcome in a patient with an extreme giant left atrium secondary to rheumatic mitral valve disease.

August 22, 2026BMC Cardiovascular DisordersOpen Access

An extreme giant left atrium exceeding 160 mm in rheumatic mitral valve disease: a case report

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Why the study?

Giant left atrium is a rare complication of chronic rheumatic mitral valve disease, presenting significant technical challenges and clinical considerations in surgical management.

Population

A 46-year-old woman with rheumatic mitral valve disease, permanent AF, and right heart failure

Design

Case report

Follow-up

Postoperative day 12

Authors

VBVinh Duc An BuiHue Central Hospital PLPhuoc Nguyen LeHue Central Hospital TVTue Minh VoSan Mateo Medical Center

Discussion

Member takes

Implication

Extreme giant left atrium complicates surgical planning in rheumatic mitral disease; leaves open optimal strategies and long-term outcomes.

Key Points

To describe the surgical approach, clinical challenges, and postoperative outcome in a patient with an extreme giant left atrium secondary to rheumatic mitral valve disease.
Assessed a 46-year-old female with rheumatic mitral valve disease, permanent atrial fibrillation, right heart failure, dysphagia, and hoarseness using chest computed tomography (N=1).
Performed surgical mitral valve replacement, tricuspid annuloplasty, and left atrial plication to reduce atrial volume.
Computed tomography revealed an extreme left atrial anteroposterior diameter of 167 mm and an estimated volume of 2,225 to 2,411 mL.
The surgical reduction was technically successful with confirmed postoperative cardiac silhouette reduction, but the patient died on postoperative day 12 from refractory low cardiac output and drug-resistant ventilator-associated pneumonia.

Structured PICO

Population

1 46-year-old woman with rheumatic mitral valve disease, permanent atrial fibrillation, right heart failure, and extreme giant left atrium (AP diameter 167 mm).

Intervention

Mitral valve replacement, tricuspid annuloplasty, and left atrial plication.

Outcome

Surgical outcome and survivalhard clinical

Surgical reduction of an extreme giant left atrium is technically feasible, but careful patient selection and preoperative optimization are crucial due to the high risk of mortality in patients with advanced right heart failure and low physiological reserve.

Limitations

Single case with fatal outcome, limiting generalizability
Postoperative computed tomography was not obtained due to rapid deterioration
Suboptimal positioning and equipment limited reliable comparison of bedside echocardiography
Comparisons with published cases should be interpreted cautiously given different imaging modalities and measurement methods

Cite This Study

Bui et al. (2026) studied this question.

synapsesocial.com/papers/6a895f9cca7ade938187e67f https://doi.org/10.1186/s12872-026-06461-w

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Implication

Extreme giant left atrium complicates surgical planning in rheumatic mitral disease; leaves open optimal strategies and long-term outcomes.

An extreme giant left atrium exceeding 160 mm in rheumatic mitral valve disease: a case report

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

An extreme giant left atrium exceeding 160 mm in rheumatic mitral valve disease: a case report

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider