Document Detail


Left atrial plication and mitral valve replacement for giant left atrium accompanying mitral lesion.
MedLine Citation:
PMID:  8507966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between January 1982 and November 1992, 38 patients received simultaneous mitral valve replacement (MVR) and left atrial plication (LAP) because of giant left atrium accompanying mitral lesion. Their ages ranged from 33 to 70 years, and the mitral lesion was caused by rheumatic heart disease in all patients. MVR was performed with a St. Jude Medical prosthesis for all patients and the left atrial wall was plicated with running 3-0 Nespolene to reduce the width to 3 to 5 cm. Respiration requiring mechanical ventilation more than 48 hours after operation occurred in four patients (10.5%) and postoperative low cardiac output requiring a high dose of dopamine HCl or intraaortic balloon pumping in nine patients (23.7%). The left atrial diameter measured by echocardiogram was a mean of 7.3 +/- 1.0 cm before operation and 5.8 +/- 1.0 cm postoperatively. The cardiothoracic ratio on the chest roentgenogram registered a preoperative mean of 73.3% +/- 9.8% and was 65.7% +/- 8.4% after operation. The pre- and postoperative values were significantly different (p < 0.01). The postoperative exercise level was a mean of 5.3 metabolic units for 24 patients and the postoperative New York Heart Association functional classification indicated Class I or II for 37 patients with no evidence of left atrial thrombus except in the case of one early death. LAP with MVR for patients with giant left atrium due to mitral lesion appeared to result in improvement in respiratory and circulatory functions.
Authors:
T Isomura; K Hisatomi; A Hirano; H Maruyama; K Kosuga; K Ohishi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  8     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-07-14     Completed Date:  1993-07-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  365-70     Citation Subset:  IM    
Affiliation:
Second Department of Surgery, Kurume University Hospital, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Dilatation, Pathologic / etiology
Female
Heart Atria / pathology,  surgery*
Heart Valve Prosthesis*
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / complications,  surgery
Mitral Valve Stenosis / complications,  surgery
Rheumatic Heart Disease / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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