Left atrial reduction in mitral valve surgery

Podchasov D.A.; Evseev E.P.; Aidamirov Ya.A.; Stonogin A.V.; Balakin E.V.; Nikityuk T.G.; Belov Yu.V.

doi:https://doi.org/10.17116/kardio202518041460

Podchasov D.A.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-4500-2344

Evseev E.P.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-3806-9658

Aidamirov Ya.A.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-3870-1040

Stonogin A.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-3628-9403

Balakin E.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-9658-6725

Nikityuk T.G.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-4192-7366

Belov Yu.V.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

SPIN RSCI: 2740-1439
Scopus AuthorID: 7101862336
ResearcherID: 7101862336
ORCID: 0000-0002-9280-8845

Left atrial reduction in mitral valve surgery

Authors:

Podchasov D.A., Evseev E.P., Aidamirov Ya.A., Stonogin A.V., Balakin E.V., Nikityuk T.G., Belov Yu.V.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2025;18(4): 460‑470

DOI: 10.17116/kardio202518041460

Read: 394 times

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To cite this article:

Podchasov DA, Evseev EP, Aidamirov YaA, Stonogin AV, Balakin EV, Nikityuk TG, Belov YuV. Left atrial reduction in mitral valve surgery. Russian Journal of Cardiology and Cardiovascular Surgery. 2025;18(4):460‑470. (In Russ.)
https://doi.org/10.17116/kardio202518041460

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To evaluate the immediate results of left atrial reduction in correction of mitral valve disease complicated by left atrial enlargement.

MATERIAL AND METHODS

A retrospective analysis of surgical treatment included 100 patients (48 men and 52 women, mean age 69.9±11.1) who underwent left atrial reduction (main group) between 2013 and 2023. Preoperative left atrial volume was 334±235 ml (200—1430). For detailed analysis, the main group was divided into two subgroups: baseline left atrium volume <300 ml (64 (64%) patients) and >300 ml (36 (36%) patients). The control group included 44 patients (23 men and 21 women, mean age 60.2±10.3 years), who underwent mitral valve surgery without left atrial reduction. Preoperative left atrial volume in the control group was 248 ml (200—550).

RESULTS

In-hospital mortality in the main group was 2%. Postoperative left atrium volume in the main group was 111±76.3 ml. Upon discharge, sinus rhythm was recorded in 61 patients (62%). In 11 patients, baseline sinus rhythm was stable after surgery. In 50 (51%) patients, sinus rhythm was restored. Among 55 patients after additional radiofrequency Cox Maze IV procedure, stable sinus rhythm was observed in 43 (78%) cases. There were no deaths in the control group. Left atrium volume decreased from 248 (220—315) to 200 (180—240) ml. Sinus rhythm was maintained or restored in 7 (16%) patients. When analyzing the correlation of sinus rhythm recovery after surgery with baseline left atrium volume and duration of atrial fibrillation, we found that the most frequent restoration of sinus rhythm was observed in patients with baseline left atrium volume <400 ml and duration of atrial fibrillation <20 months.

CONCLUSION

Left atrial reduction improves postoperative outcomes in this complex group of patients. Correction of heart valve disease and left atrial reduction are effective to restore sinus rhythm.

Keywords:

left atrial enlargement

giant left atrium

left atrial reduction

mitral valve disease

atrial fibrillation

Authors:

Podchasov D.A.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-4500-2344

Evseev E.P.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-3806-9658

Aidamirov Ya.A.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-3870-1040

Stonogin A.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-3628-9403

Balakin E.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-9658-6725

Nikityuk T.G.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-4192-7366

Belov Yu.V.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

SPIN RSCI: 2740-1439
Scopus AuthorID: 7101862336
ResearcherID: 7101862336
ORCID: 0000-0002-9280-8845

Received:

10.02.2025

Accepted:

23.03.2025

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References:

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