Title : Plasty of left atrium for atriomegaly during mitral valve correction
Abstract:
Objective: To determined possibillities of left atrium (LA)`s reduction by original method of triangular plasty of LA (TPLA) during valve`correction replacement.
Methods: During 2005 – 2021 yy. 725 adult patients (pts) with MVD and LA`s atriomegaly (diameter of LA > 60 mm) average 69,7 ± 1,8 mm were operated at Institute. Mitral valve correction ( mainly MVR) were performed in 687 pts, MV`s plasty in 38 pts. There were 330 (45,5%) males, 395 (54,5%) females. Average age was 53,4 ± 7,4 yy. There were 428 (59,0%) in IY NYHA class and 297 (41,0%) in III class. All data divided at 2 groups: group A (main) - TPLA + resection of LA`s auriculum was 148 pts and group B (control) – 577 pts only correction of valve pathology without LA`s plasty or resection`s auriculum. All operations were performed with CPB, moderate hypothermia with crystalloid cardioplegia. Cross-clamping time of aorta (min) were: group A - 95,4 ± 13,2 and group B - 73,2 ± 9,2 (p< 0,05).
Results: The hospital mortality were: in group A - 2,0% (n=3/148) and in group B - 2,6% (n=15/577) (p<0,05). At the remote period (average was 12,2± 2,7 yy) 671 (93,5%) pts were followed–up. Data of echo for group A (n=139) : diameter of LA (mm) - preoperative (PRE) - 70,4 ± 1,8, postoperative (POST) - 52,6 ± 1,2, remote period (RP) - 53,5 ± 1,3; ejection fraction of LV (EFLV): PRE – 0,53 ± 0,05, POST - 0,55 ± 0,04, RP - 0,57 ± 0,0 .Data of echo for group B were (n=532) : diameter of LA (mm): PRE- 69,8 ± 2,5 , POST - 67,4 ± 1,8, RP - 78,1 ± 1,9; EFLV: PRE – 0,52 ± 0,04 , POST - 0,54 ± 0,05, RP – 0,53 ± 0,04 . At remote period thrombembolic events and lethal events were marked respectively: in group A -5,9% and 1,1% and in group B -17,8% and 9,3% (p<0,05).
Conclusion: The original method of TPLA was allowing to improve better clinical results at group A than in B (p<0,05).
