Triangular plasty of left atrium in a left-sided atriomegaly

Abstract

Objective. Studying possibilities of the triangular plasty of left atrium procedure, performed while prosthesis of a mitral valve.
 Materials and metods. Into the main group 137 patients, suffering isolated mitral failure, complicated by left atriomegaly (diameter of left atrium ≥ 6.0 cм), to whom surgical treatment was performed in Amosov National Institute of Cardiovascular Surgery from 01.10.2010 to 01.01.2019 yr, were included. In all the patients a prosthesis of a mitral valve, preserving native structures of a mitral valve with reduction of the left atrium cavity, using procedure of the left atrium triangular plasty, was performed. Into a control group were included 57 patients, in whom a mitral valve correction without a left atrium reduction was performed only for a mitral valve failure and a left-sided atriomegaly (diameter of left atrium was ≥ 6.0 cm).
 Results. Of 137 patients of the main group on the hospital stage 3 (2.2%) have died. Dynamics of echocardiographic indices of the left atrium diameter on different stages was following: (65.5 ± 3.8) mm preoperatively, (51.5 ± 2.1) mm postoperatively, (52.5 ± 2.2) mm in a remote follow-up period, in a remote follow-up period in (5.1 ± 0.4) years at average, thromboembolic complications (the transient disorders of the brain blood circulation) were noted in (1.6%) of 125 patients.
 Of 57 patients of a control group on the hospital stage 2 (3.5%) have died. Dynamics of echocardiographic indices, concerning diameter of the left atrium on various stages was following: (66.7 ± 2.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in the remote follow-up period. In the remote follow-up period in (7.1 ± 0.4) years, thromboembolic complications were noted in 7 (14.6%) of 48 patients.
 Conclusion. The procedure of triangular plasty of left atrium constitutes an obligatory stage while performing correction of a mitral failure in presence of a left-sided atriomegaly (diameter of left atrium ≥ 6.0 cm). The procedure is miniinvasive and effective, leads to significant improvement of the left atrium morphometry and is accompanied by low risk of the complications occurrence and hospital mortality. The data accumulated and estimation of remote results of the procedure permits her to occupy a significant place among other methods of atrioplasty.