Atrioplasty techniques in patients with mitral valve disease and left atriomegaly

Left atrium (LA) enlargement (left atriomegaly) is a common complication of mitral valve (MV) disease that occurs in 20% of patients.To reduce LA volume in 102 patients with MV disease, 3 different surgical techniques were used: Kawazoe technique (Group 1),"Mercedes"technique (Group 2), and resectional atrioplasty (Group 3). Hospital mortality rate was 4.9%. LA volume reduction ranged from 6.7±0.6 to 4.7±0.5 mm in Group 1,6.8±1.0 to 5.0±0.6 mm in Group 2 and 7.0±1.5 to 4.65±1.0 mm in Group 3.The cardiothoracic index and the tracheal bifurcation angle also tended to decrease. During long-term follow-up, the sinus rhythm persisted in 57% of patients, with no use of antiarrhythmic pharmacotherapy. Thus, LA volume-reduction interventions in patients with MV disease result in LA size reduction, transmitral flow normalization and reduction of the risk of thromboembolism.