Echocardiography changes in pre and post-operative patients who under gone mitral valve replacement in concerned with left atrial size

ABSTRACT

Background: The most frequent cause of atrial fibrillation is atrial dilatation resulting from volume or pressure overload of the heart, which may occur in ischemic heart disease, valvular disease, dilated cardiomyopathy, chronic heart failure or, less frequently, due to degenerative, inflammatory or fibrous disease. Aim of the study Echocardiography changes in pre and post-operative patients who under gone mitral value replacement in concerned with left atrial size. Materials and methods: Totally 76 patients were included in the study. The study was conducted in the department of cardiothoracic surgery, Government Mohan Kumaramangalam Medical College Hospital, from 2015-2018. 76 patients underwent isolated mitral two groups were identified based on left atrial size Group 1 <60 mm (n=44) and Group 2 >60 mm (n=32). Clinical assessment, preoperative and last postoperative echocardiograms were considered for analysis. Results: The left atrium decreased by 5.84 mm 10.5 in group 1 compared to 20.9 mm 10.64 in group 2 (p=0.0001). This correlated with preoperative mitral valve area (p=0.009), preoperative mitral regurgitation (p=0.000), and preoperative atrial fibrillation (p=0.022). Linear regression analysis revealed atrial fibrillation (p=0.001, b1=6.006), a high grade of mitral regurgitation (p=0.001, b1=3.812), and larger size of the left atrium (p=0.000, b1=0.701) predicted a greater reduction of left atrial size during follow-up. Left atrial size decreased by 28mm in patients with a preoperative left atrium >60 mm (75% sensitivity and 100% specificity). Pon. A. Rajarajan, R. Vijay Anand. Echocardiography changes in pre and post-operative patients who under gone mitral valve replacement in concerned with left atrial size. IAIM, 2019; 6(3) 105-110. Page 106 Conclusion: The asymptomatic left atrium reduces in size considerably after mitral valve replacement, and the decrease is greater in patients with a left atrium >60 mm in size. Surgical treatment of mitral valve disease results in a significant reduction of left atrial size and, in some patients, also in the restoration of sinus rhythm.