Limit of Indication for Plication of Giant Left Atrium

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.