Effects of Left Atrial Plication for Gian Left Atrium on Left Ventricular Function and Postoperative Hemodynamics

Giant left atrium secondary to mitral valvular disease frequently produces postoperative hemodynamical and respiratory management problems due to compression on the neighbouring tissues. In this study we investigated the effects of left atrial plication (LAP) particularly on left ventricular function and postoperative hemodynamics in the patients with mitral valvular disease and giant left atrium. Twenty-seven patients with mitral valvular disease and left atrial dimension of 60 mm or over were included to the study. In addition to mitral valvular surgery, left atrial plication (LAP) according to Kawazoe's method was performed on 12 patients (LAP group); no surgical intervention to the giant left atrium was performed in the other 15 patients (non-LAP group). Two groups were compared with respect to hemodynamic windings in the early postoperative period: In LAP group, stroke volume index (STRVI) was significantly higher, diuretic requirement was significantly lower and sinus rhythm was more frequent (STRVI: 47±6 and 38±7 ml/m2, furosemide requirement 24±19 and 45±28 mg per patient, sinus rhythm: 67% and 27% in LAP and non-LAP groups, respectively, p<0.05). Hence, LAP has a beneficial effect on left ventricular function and hemodynamic findings patients with giant left atrium.