Key result
Mitral valve replacement with left atrial reduction leads to fatal operative complication in giant LA.
Why the study?
Giant left atrium secondary to severe mixed mitral valve pathology is a rare clinical presentation requiring detailed imaging and surgical intervention.
Case Report (n=1)
A case report illustrating a giant left atrium secondary to rheumatic mixed mitral valve pathology, treated with surgery but resulting in a fatal operative complication.
High operative risk in giant isolated LA enlargement warrants careful selection; leaves open optimal plication techniques in rheumatic mitral disease.
A 76-year-old female presented with rheumatic mixed mitral valve pathology. A chest X-ray revealed massive cardiomegaly and splaying of the carina (Fig. 1 ). CT scan showed gross isolated left atrial (LA) enlargement (Fig. 2a ), which was plicated from within (Fig. 2b). A mitral valve replacement and LA reduction was performed but she died of an operative complication. Chest X-ray shows massive cardiomegaly (cardiothoracic ratio = 1) with splaying of the carina. (a) Contrast-enhanced CT scan shows gross enlargement of the left atrium filling the width of the thorax. (b) Intraoperative picture showing the bulky plication suture line of giant LA appendage from within the left atrium.
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Rajakaruna et al. (2007) conducted a case report in Rheumatic mixed mitral valve pathology with giant left atrium (n=1). Mitral valve replacement and left atrial reduction was evaluated on Operative outcome. Mitral valve replacement and left atrial reduction in a 76-year-old female with a giant left atrium secondary to rheumatic mitral valve pathology resulted in death from an operative complication.
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