1/22. Right lateral transthoracic approach mimicking standard transesophageal echocardiographic views in a patient with giant left atrium.We describe the case of a patient with long-standing severe mitral periprosthetic regurgitation and a giant left atrium. The patient was referred for surgery. On the third postoperative day, after resuture of the dehiscence of the valve sewing ring, the patient complained of dyspnea. Transthoracic ultrasound examination was performed to eliminate pleural effusion. The severe right lateral displacement of an aneurysmatic left atrial cavity contacting with the thoracic wall allowed us to obtain excellent images of the posterior cardiac anatomy by a right lateral thoracic view. The new transthoracic approach made it possible to safely assess the atrial side of the mitral prosthesis, eliminating mitral regurgitation after surgery without transesophageal echocardiographic examination.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. Autotransplantation procedure for giant left atrium repair.BACKGROUND: Giant left atrium has been associated with bronchopulmonary and left ventricular compression [Kawazoe 1983]. CASE REPORT: 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. Mitral prosthetic function and ventricular systolic function were felt to be normal leading to a tentative diagnosis of diastolic restriction from left ventricular compression and pericardial constriction. A pericardial decortication procedure through left thoracotomy was initially done but proved ineffective. Subsequently, full evidence of hemodynamic failure due to the giant left atrium and its respiratory complication was recognized and the patient underwent cardiac autotransplantation procedure [Kosak 1987], with the aim to reduce the left atrial dimensions to normal. CONCLUSIONS: 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 complications. This case provides ample evidence that GLA can cause respiratory failure and needs to be surgically corrected.- - - - - - - - - - ranking = 1.2keywords = giant (Clic here for more details about this article) |
3/22. A novel technique for giant left atrium reduction.We herein describe a safe and reproducible technique for left atrial volume reduction in patients with a giant left atrium. In a 56-year-old patient undergoing redo mitral valve replacement, the left atrium measured 18 x 20 x 17 cm occupying the middle-lower segment of the right hemithorax with compression of the adjacent organs. The left atrial volume was reduced by triangular resections of the atrial wall and the mitral valve was replaced using a mechanical prosthesis. The postoperative course was uneventful and the left atrial diameter was 11.2 cm at the latest control.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/22. Left atrial reduction and mitral valve replacement in a 5-year-old girl with severe mitral regurgitation and giant left atrium.Giant left atrium associated with mitral valve disease has been implicated in the morbidity following mitral valve repair or replacement. Various methods including left atrial plication have been described to reduce the size of left atrium. Herein we describe our technique of left atrial reduction in a 5-year-old girl with severe mitral regurgitation and giant left atrium. She underwent mitral valve replacement and circumferential left atrial reduction with successful outcome.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/22. Congenitally unguarded tricuspid valve orifice with a giant right atrium and a massive clot in an asymptomatic adult.Congenitally unguarded tricuspid valve orifice, a variant of tricuspid valve dysplasia, is a rare malformation with protean manifestations. This report describes an asymptomatic adult who, on echocardiographic examination ordered in view of an abnormal 12-lead surface electrocardiogram and plain chest X-ray, was found to have an unguarded tricuspid valve orifice with a giant right atrium (12 x 10 cm), intense spontaneous echo contrast and a large right atrial clot.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/22. Giant hiatal hernia presenting with stable angina pectoris and syncope--a case report.A 70-year-old woman with giant hiatal hernia presented with stable angina pectoris and three syncope attacks in the previous 3 months. Chest radiography showed marked cardiomegaly and an air-fluid level at the basal region of the heart. A mixed type large hiatal hernia that distorted the heart was detected in contrast-enhanced computed tomography and esophagogastroduodenography. Postprandial nonsustained ventricular tachycardia was present on 24-hour Holter ECG monitoring. The patient's symptoms were attributed to giant hiatal hernia and improved following surgery.- - - - - - - - - - ranking = 0.4keywords = giant (Clic here for more details about this article) |
7/22. Right atrial reduction for tachyarrhythmias in Ebstein's anomaly in infancy.A 20-month-old girl with Ebstein's anomaly developed supraventricular paroxysmal tachycardia, which seemed to be a result of the wall tension of the giant right atrium. Right atrial resection reduced the wall tension and overall dimensions of the right atrium and finally resolved the tachycardia and ectopic electrical conduction. Six-year follow-up electrocardiograms confirmed continuing normal sinus rhythm without occurrence of supraventricular paroxysmal tachycardia or other ectopic electrical activity The follow-up echocardiograms showed the size of the right atrium to be unchanged from the time of operation. There are few data in the available literature about performing right atriotomy to resolve a tachyarrhythmia associated with Ebstein's anomaly and none, to the best of our knowledge, about performing right atrial resection for this purpose.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
8/22. Asymptomatic giant right atrial aneurysm.A 5-year-old asymptomatic boy was found incidentally, on a chest radiograph, to have gross cardiomegaly; further evaluation by echocardiography showed a giant right atrial aneurysm. The patient underwent successful surgical reduction of the right atrium, closure of an atrial septal defect, and tricuspid valve repair These measures were taken to prevent thrombus formation in the right atrium, prevent paradoxical embolism, and lower the risk of atrial arrhythmias. The morphologic features of the resected atrial tissue showed paper-thin wall with a central aneurysm and focal endocardial fibrosis consistent with a diagnosis of idiopathic dilatation of the right atrium.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/22. Bronchial carcinoma with eosinophilia and cardiomegaly.A patient with a giant cell carcinoma of the bronchus presented with headache and flushing attacks and a blood eosinophilia. He developed a right bundle branch block and later congestive cardiac failure. At post mortem he was found to have the appearance of Loeffler's endocarditis. A tentative mechanism for these events is proposed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
10/22. Thrombosed giant left atrium mimicking a mediastinal tumor.A patient with rheumatic heart disease, mitral stenosis, and mitral insufficiency is described. The thrombosed giant left atrium paralyzed the left vocal cord and completely obstructed the bronchi to the middle and lower lobes of the right lung. The giant left atrium mimicked a mediastinal tumor on the chest x-ray film.- - - - - - - - - - ranking = 1.2keywords = giant (Clic here for more details about this article) |
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