scholarly journals Results of surgical correction of gigantic left atrium

2020 ◽  
Vol 4 (Issue 2) ◽  
pp. 67
Author(s):  
Rustem Tuleutayev ◽  
Daurenbek Urazbekov ◽  
Kuat Abzaliyev ◽  
Baurjan Rakishev ◽  
Nazym Nurollaeva ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Atrial Volume ◽  
X Ray ◽  
Chest X Ray ◽  
Leg Edema ◽  
Tricuspid Valve Annuloplasty ◽  
Left Atrial Dilatation

We presented a clinical case of surgical treatment of gigantic left atrium in longstanding mitral regurgitation due to mitral valve disease diagnosed 23 years ago (patient refused surgery and was on medical treatment) and complicated by atrial fibrillation. The patient was referred for surgery with complaints on severe dyspnea on minimal exertion, weakness, fatigue, palpitations and massive leg edema. Diagnosis was established using electrocardiography, chest X-Ray, transthoracic and transesophageal echocardiography, and computed tomography. The patient underwent mitral valve replacement, tricuspid valve annuloplasty and left atrial reduction surgery (atrioplasty by Kawazoe). After surgery, left atrial volume decreased from 813 ml to 294 ml and antero-posterior size from 11.2 to 6.2 cm. The patient was discharged on 8th day after surgery. Control examinations after 6 months and 1 year showed reduction of left atrial volume (319 ml and 294 ml); patient feels well and has no complaints. Thus, our case demonstrated reduction of left atrium early in postoperative period and its slow reduction after surgery during 1 year. It is also showed human reserve capacity and possibility of left atrial dilatation to such sizes. Late diagnosis of such changes in heart is possibly related to the fact that patient was afraid to see doctors and undergo surgery. The left atrial cavity size determination can be done intraoperatively using method of surgical glove we suggested. 

scholarly journals Left Atrial Volume Correlates with Mitral Annulus Size: An MDCT Study

2021 ◽  
Vol 11 (23) ◽  
pp. 11329
Author(s):  
Gabriel Cismaru ◽  
Iulia Valean ◽  
Mihnea Cantemir Zirbo ◽  
Alexandru Tirpe ◽  
Andrei Cismaru ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Left Atrial ◽  
Three Dimensional ◽  
Left Atrial Volume ◽  
Persistent Atrial Fibrillation ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Atrial Volume ◽  
Minimum Age

Aim: Although the association between left ventricular dilation and mitral annulus dilation is well understood, the potential variation in the size of the mitral annulus during dilation of the left atrium is currently unknown. In order to investigate the link between the two variables, we used multidetector computed tomography (MDCT) and looked at patients who had a dilated left atrium, assessing if the mitral valve also dilates. Materials and Methods: The study included 107 patients with paroxysmal and persistent atrial fibrillation, in whom catheter ablation was performed using pulmonary vein isolation ± atrial substrate modification. Eighty patients were male (74.8%), with a mean age of 55.8 years (±9.87 with a minimum age of 26 years and a maximum age of 79 years), of which 57.1% had paroxysmal AF and the rest had persistent fibrillation. All the patients underwent multiple-detector CT (MDCT) with contrast medium before the ablation. CT images were integrated into the three-dimensional mapping system CARTO 3, after which the diameters of the mitral annulus, area, and circumference were measured. Left atrial size was evaluated by measuring the diameters, area, and volume. Results: The left atrial area was 247 ± 65.7 cm2 and the left atrial volume was 139 ± 56.3 mL. The transverse mitral annulus (MA) was 29.9 ± 5.3 mm and the longitudinal diameter was 41.9 ± 7.6 mm. The MA circumference and area were 15.0 ± 3.5 cm and 14.2 ± 4.6 cm2, respectively. The following statistically significant correlation was identified between the dimensions of the mitral annulus and the diameters of the left atrium: the transverse mitral annulus correlates with the antero-posterior (AP) LA diameter (R = 0.594, p < 0.01) and the longitudinal MA diameter correlates with the latero-lateral (LL) LA diameter (R = 0.576, p < 0.01). Furthermore, the MA area correlates with the LA volume (R = 0.639, p < 0.001). Conclusions: The volume of the left atrium correlates with the area of the mitral annulus. In patients with paroxysmal and persistent AF, an increase in left atrial dimensions is further associated with an increase in mitral valve dimensions.

scholarly journals Determination of left atrial volume in healthy dogs and dogs with myxomatous mitral valve disease

2016 ◽  
Vol 36 (8) ◽  
pp. 743-748
Author(s):  
Rodrigo P. Franco ◽  
Evandro Zacche ◽  
Rafael R. Camacho ◽  
Marlos G. Sousa ◽  
Aparecido A. Camacho
Keyword(s):  
Body Weight ◽  
Mitral Valve ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
The Body ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Atrial Volume ◽  
Atrial Enlargement ◽  
Healthy Dogs

Abstract: The left atrial volume (LAV) can be obtained using the biplane Simpson's method via echocardiography. Although in medicine this parameter has been considered to be a prognostic marker of left atrial enlargement in several cardiac diseases, in dogs with myxomatous mitral valve degeneration (MMVD), a valvulopathy characterized by left atrial (LA) volume overload, atrial enlargement is usually assessed by the LA-to-Aorta ratio (LA:Ao). Therefore, the body surface area (BSA)-indexed LAV was measured in healthy dogs and in dogs with MMVD using the biplane Simpson's method. For this purpose, a total of 107 healthy dogs (control) and 81 dogs with MMVD in ACVIM stages B1, B2 and C were assessed, with LAV being calculated during atrial diastole (d) and systole (s) through the biplane Simpson's method. Two-dimensional apical four-chamber (4C) and two-chamber (2C) images were obtained in every dog through the left parasternal window. The values obtained from healthy dogs were correlated with body weight using Pearson's test. An analysis of variance (ANOVA) and Tukey's test were used to compare healthy and MMVD dogs, as well as to investigate differences according with MMVD stages. A strong positive correlation was documented between either LAVd (r> 0.77) or LAVs (r> 0.73) and body weight in healthy dogs. The BSA-indexed LAV calculated for MMVD dogs was significantly different (p<0.01) from that obtained for the control group. Also, LAV was significantly different (P<0.05) when stages B2 and C, and B1 and C were compared. In conclusion, this study provided a reference for left atrial volume and the applicability of this technique to assess atrial overload in dogs with varying-stage MMVD.

scholarly journals Porcelain Atrium: A Case Report with Literature Review

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Krystle Leacock ◽  
Andre J. Duerinckx ◽  
Bonnie Davis
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Radiographic Imaging ◽  
Atrial Wall ◽  
X Ray ◽  
Left Atrial Wall ◽  
Nigerian Woman ◽  
Wall Calcification ◽  
Noncontrast Ct ◽  
Chest X Ray

Massive left atrial wall calcification, or porcelain atrium, is very rare. We describe a case of an unusual pattern of cardiac calcification demonstrated on routine preoperative chest X-ray for cataract surgery in a 71-year-old Nigerian woman. Past medical history was significant for mitral stenosis and atrial fibrillation. Radiographic imaging revealed curvilinear high density areas of calcification outlining the left atrium on the chest X-ray. Noncontrast CT scan of the thorax confirmed the left atrial distribution of calcification and, thus, the diagnosis of porcelain left atrium.

scholarly journals Variation of Left Atrial Function in Different Stages of Mitral Regurgitation and Its Association With Guidelines-Based Surgical Indication

2020 ◽  
Vol 23 (6) ◽  
pp. E746-E751
Author(s):  
Fengming Bai ◽  
Lingfei Cun ◽  
Bo Li
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Atrial Volume ◽  
Current Guidelines

Purpose: The current guidelines associate indications for surgery in mitral regurgitation (MR) with left ventricle size and function. However, there is not enough emphasis in current guidelines on left atrial function, which is thought to be an important factor predicting adverse outcomes in MR. The aim of this study was to investigate the left atrial function at different stages of mitral regurgitation and its value in predicting the indications of mitral valve surgery. Methods: This was a retrospective study with 163 consecutive chronic primary MR patients who underwent color doppler echocardiography at the Guangxi Zhuang Autonomous Region Second People's Hospital between January 2016 and June 2018. All patients were in sinus rhythm, classified into three groups, according the degree of mitral regurgitation. Comparison was made with 30 control patients. Using Simpson’s methods, we recorded maximal left atrial volume, left atrial volume before active contraction and minimal left atrial volume, from which left atrial expansion index, left atrial passive emptying fraction, left atrial active emptying fraction, and the total left atrial emptying fraction were derived. Results: Left atrial volume was expanded and left atrial emptying fraction was reduced in the mitral regurgitation group. By multivariate analysis, left atrial passive emptying fraction and left atrial active emptying fraction were independent predictors of mitral regurgitation requiring surgery. Using receiver-operating characteristic analysis, left atrial passive emptying fraction <97.4% demonstrated 98% sensitivity and 67% specificity for predicting the presence of surgical indication (area under the curve: 0.91; P < .001). Conclusion: During mitral regurgitation, left atrial volume increases and functions decrease. The left atrial passive emptying fraction can be used as an additional tool to predict the indications of mitral valve surgery.

scholarly journals Mitral prolapsing volume is associated with increased cardiac dimensions in patients with mitral annular disjunction

2021 ◽  
Author(s):  
P. Luyten ◽  
S. Heuts ◽  
E. Cheriex ◽  
J. R. Olsthoorn ◽  
H. J. G. M. Crijns ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Valve Disease ◽  
Control Group ◽  
Additional Parameter ◽  
Atrial Volume ◽  
Volume Shift

Abstract Introduction In patients with mitral annular disjunction (MAD), it can be difficult to assess the severity of mitral regurgitation (MR), as they present with a prolapsing volume (i.e. volume resulting from mitral valve prolapse, blood volume shift) rather than a regurgitant jet. The influence of the mitral prolapsing volume (MPV) on cardiac dimensions is unknown. We hypothesised that the severity of MR is underestimated in these patients. Our aim was to measure MPV and to investigate its influence on cardiac dimensions in patients with MAD. Methods We retrospectively included 131 consecutive patients with MAD from our institution’s echocardiographic database. Transthoracic echocardiography was used to assess MPV. Additionally, we established a control group of 617 consecutive patients with degenerative mitral valve disease and performed propensity score matching. Results Median MPV in the MAD group was 12 ml. MPV was an independent predictor for left ventricular end-diastolic (LVEDD) and end-systolic diameter (LVESD) and left atrial volume (all p < 0.001). In patients with large prolapsing volumes (> 15 ml), LVEDD (56 ± 6 mm vs 51 ± 6 mm, p < 0.001), LVESD [38 mm (34–41) vs 34 mm (31–39), p < 0.01] and left atrial volume [105 ml (86–159) vs 101 ml (66–123), p = 0.04] were significantly increased compared to matched patients with degenerative mitral valve disease and similarly assessed severity of MR. Conclusion Due to a volume shift based on the MPV rather than an actual regurgitant jet, MR severity cannot be assessed adequately in MAD patients. Increased MPV induces ventricular and atrial enlargement. These findings warrant future studies to focus on MPV as an additional parameter for assessment of the severity of MR in MAD patients.

Abstract 17000: Quantifying Mitral Annular Calcification Using Echocardiography: Comparison to MAC Calcium Score From Gated Computed Tomography

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
William Harvey ◽  
Sheldon Litwin
Keyword(s):  
Computed Tomography ◽  
Mitral Valve ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Calcium Score ◽  
Mitral Annulus ◽  
Atrial Volume ◽  
Mitral Annular Calcification ◽  
Close Proximity ◽  
Annular Calcification

Introduction: Mitral Annular Calcification (MAC) is present in 25-40% of people ≥ 60 years old and has associations with atrial fibrillation, stroke, endocarditis, mitral regurgitation, and mitral stenosis. MAC poses major challenges to surgical or transcatheter mitral valve interventions. Current echocardiographic methods for assessing MAC are limited. Goals: To assess transthoracic echocardiographic (TTE) approaches for quantifying MAC severity compared to a gold standard of MAC calcium score by gated computed tomography (CT). Methods: 75 patients undergoing evaluation for TAVR had TTE and CT in close proximity. MAC area and circumference were measured in parasternal long-axis (PLAX), parasternal short-axis (PSAX), and apical 2, 3, and 4-chamber views on TTE. Mitral valve gradients and left atrial volume were recorded. The curvilinear length of MAC in the PSAX view on TTE and cardiac CT were also measured. Associations between various TTE measures and MAC calcium score were assessed using linear regression. Results: Median age was 75.3, 50.4% female, 85.3% Caucasian. MAC area and circumference in PSAX on TTE showed moderate correlations (R 2 =0.32-0.37) with MAC calcium score. Curvilinear MAC length measures on SAX TTE and CT had improved correlation with MAC score (R 2 =0.41 & 0.78, Figure). Combined circumference of MAC from PLAX+PSAX had the strongest association (R 2 = 0.48). Interobserver variability on CT and TTE had coefficients of variation ranging 17-37%. Left atrial volume and mitral valve gradients had weak associations with MAC severity (R 2 =0.03-0.12). Tertiles of MAC calcium scores were 2650, 5150 and 7750. Conclusions: MAC length in the PSAX view showed the strongest association with MAC severity. Dedicated PSAX views of the mitral annulus may improve the ability to reproducibly grade MAC severity by echo.

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