IMAGES IN CARDIAC SURGERY
Giant left atrium
Xiaojun Xie MMS
Jiao Bai MMS
Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou, China
Xiaojun Xie MMS, Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
A giant left atrium (LA) may be the result of congenital aneurysms,
chronic atrial fibrillation with thrombi.
We present images of a giant
LA in a patient with long-standing rheumatic heart disease.
A 72-year-old male presented with atrial fibrillation and congestive
heart failure 40 years following an open mitral commissurotomy. A chest
X-ray revealed cardiomegaly (Figure 1A), and a transthoracic echocardio-
gram showed a giant LA, severe mitral stenosis (mean mitral gradient: 16
mmHg), and moderate tricuspid regurgitation (Figures 1B–D). A computed
tomography scan showed that the LA measured 20.0 × 13.7 cm
compressed the left ventricle, right ventricle, and right atrium (Figure 1E).
mechanical prosthesis, St. Jude Medical, St. Paul, MN), an LA reduction,
and tricuspid valve repair with a MC3 ring (size 30; Edwards Lifesciences,
Irvine, CA). The patient tolerated the procedure well and a post-operative
FIGURE 1 A, Chest radiogram showing marked cardiomegaly. B–D, Transthoracic echocardiography showing a giant left atrium associated
with severe mitral stenosis and moderate tricuspid regurgitation. E, Computed tomography revealing a giant left atrium with compression of
adjacent chambers of the heart. F, Postoperative chest radiogram showing a marked reduction of cardiothoracic ratio
J Card Surg. 2018;33:97–98. wileyonlinelibrary.com/journal/jocs © 2018 Wiley Periodicals, Inc.