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Eur J Cardiothorac Surg 2007;32:932. doi:10.1016/j.ejcts.2007.08.029
Copyright © 2007, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Chanaka Rajakaruna
Jatin Desai
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Images in cardio-thoracic surgery

Giant left atrium secondary to severe mixed mitral valve pathology

Chanaka Rajakaruna*, Peter Mhandu, Michael Ghosh-Dastidar, Jatin Desai

Department of Cardiothoracic Surgery, Kings College Hospital, London, UK

Received 6 June 2007; received in revised form 15 August 2007; accepted 24 August 2007.

* Corresponding author. Address: Department of Cardiac Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK. Tel.: +44 203 299 4341; fax: +44 203 299 3433. (Email: cha.rajakaruna{at}doctors.org.uk).

Key Words: Mitral valve replacement • Giant left atrium • Gross enlargement of left atrium

A 76-year-old female presented with rheumatic mixed mitral valve pathology. A chest X-ray revealed massive cardiomegaly and splaying of the carina (Fig. 1 ). CT scan showed gross isolated left atrial (LA) enlargement (Fig. 2a), which was plicated from within (Fig. 2b). A mitral valve replacement and LA reduction was performed but she died of an operative complication.


Figure 1
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  		Fig. 1. Chest X-ray shows massive cardiomegaly (cardiothoracic ratio = 1) with splaying of the carina.

 

Figure 2
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  		Fig. 2. (a) Contrast-enhanced CT scan shows gross enlargement of the left atrium filling the width of the thorax. (b) Intraoperative picture showing the bulky plication suture line of giant LA appendage from within the left atrium.

 





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Jatin Desai
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