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Giant Left Atrium


Presentation

  • We are presenting a case of rheumatic valvular heart disease with giant left atrium who presented in our department with acute upper GI bleeding.[ncbi.nlm.nih.gov]
  • Franco Pertoldi Affiliation not present. Eleonora Ficarra Affiliation not present. Francesco Pelizzo Affiliation not present. Olga Vriz Affiliation not present.[monaldi-archives.org]
Respiratory Insufficiency
  • We present a patient with severe congestive heart failure (CHF), respiratory insufficiency and a giant left atrium (GLA) following two previous mitral valve procedures and tricuspid valve annuloplasty in the distant past.[ncbi.nlm.nih.gov]
Heart Disease
  • We discuss a case of a 78-year-old lady with no prior history of rheumatic heart disease with these findings with the unusual presentation of accompanied unilateral breast oedema as a manifestation of heart failure.[ncbi.nlm.nih.gov]
Hepatojugular Reflux
  • No signs of volume retention such as distension of the jugular veins, peripheral edema or positive hepatojugular reflux were present.[wjgnet.com]
Nocturia
  • COMMENTS Case characteristics A 78-year-old patient with rheumatic heart disease and no cardiac symptoms such as dyspnea, nocturia, chest pain or palpitations.[wjgnet.com]

Treatment

  • Abstract We report on the usefulness of a combined superior-transseptal approach for the surgical treatment of giant left atrium. The posteroinferior wall and the roof of the left atrium were easily plicated and the mitral valve procedure was simple.[ncbi.nlm.nih.gov]
  • Surgeon Mike Gordeev Different methods of left atrium walls suture application are widely used as a surgical option for atriomegaly treatment and sinus rhythm recovery. These techniques may also be accomplished by Cox-Maze procedure.[healthcare-in-europe.com]

Prognosis

  • There are several reasons why left atrial size can have a significantly negative impact on prognosis.[ncbi.nlm.nih.gov]
  • […] is dependent on the adequacy of the residual left ventricular function, patients with severe left ventricular dysfunction having higher mortality rates. 25 In this case the early prognosis was favorable, but on the long term, the prognosis still remains[tmj.ro]
  • Long- and short-term prognosis is excellent and recurrence is rare, although six-monthly echocardiographic follow-up is recommended in all cases. 1 With this case report, we aim to highlight the fact that a diagnosis as common in daily clinical practice[elsevier.pt]
  • The patient’s family was notified of the poor prognosis and the decision was made not to resuscitate her if her condition deteriorated further. The patient ultimately became bradycardic and went into asystole at 5: 30 am.[bjmp.org]

Etiology

  • Abstract Giant left atrium is a rare condition, with a reported incidence of 0.3%, that is normally caused by rheumatic mitral valve disease but very rarely is caused by other etiologies.[ncbi.nlm.nih.gov]
  • Probably the best known of the vascular etiologic types is dysphagia lusoria. Dysphagia lusoria is the term applied to symptomatic esophageal compression by an arteria lusoria, an anomalous form of the right subclavian artery (1, 2).[annals.org]
  • In a patient, the congenital etiology was severe with mitral and tricuspid valve insufficiency and with GLA.[rbccv.org.br]
  • Conclusion Giant atria due to rheumatic etiology are still prevalent in developing nations. Despite massive enlargement many patients may remain asymptomatic.[jcecho.org]
  • We performed tridimensional (3D) transthoracic echocardiography to study the etiology of MR.[tmj.ro]

Pathophysiology

  • They examine the causes, pathophysiology, investigation, diagnosis, and treatment (pharmacological and non-pharmacological) with emphasis on recently-published studies.[books.google.com]
  • Giant Left Atrium Pathophysiology: The commonest cause of a large left atrium is mitral regurgitation, usually due to rheumatic heart disease.[individual.utoronto.ca]
  • Pathophysiology of mitral valve disease. In: Cohn LH, Edmunds LH Jr, editors. Cardiac Surgery in the Adult. New York, USA: McGraw-Hill; 2003. p. 901-31. 3. Surani S, Surani A, Varon J. Giant right atrium secondary to mitral stenosis.[jcecho.org]
  • Left ventricular aneurysms: pathophysiologic observations and standard resection. Sem Thorac Cardiovasc Surg 1997;9:113-22. 9. Grieco JG, Montoya A, Sullivan HJ, et al. Ventricular aneurysm due to blunt chest injury.[tmj.ro]

Prevention

  • Calcification of posterior left atrial wall prevented a completely satisfactory reduction of atrial size and the severity of ventricular adhesions from the previous pericardial procedure resulted in very long cardiopulmonary bypass time with severe bleeding[ncbi.nlm.nih.gov]
  • Volume reduction is useful to prevent complications; the indication for surgery is the presence of intracardiac or extracardiac compressive symptoms and several techniques have been proposed such as simple wall placation or resection and primary suture[romanianjournalcardiology.ro]
  • Surgical treatment seems to be important in management of LAAA even in the absence of symptoms to prevent complications [1,3,8,10].[elynsgroup.com]
  • References European Atrial Fibrillation Trial Study Group: Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993;342:1255-1262.[karger.com]
  • Regardless of mechanism, the diagnosis of a left atrial thrombus ball should be regarded as an urgent indication for preventive surgery( 3 ).[ispub.com]

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