[The causes of prolonged postoperative respiratory care in mitral valve disease with a giant left atrium].

Whether a giant left atrium in mitral valve disease itself prolongs postoperative respiratory care or does not is an important problem. We investigated it in 39 patients who underwent MVR without plication of the left atrium. A giant left atrium (GLA) was defined when CT-LA volume exceeded 300 ml by rapid sequential CT or left atrial diameter exceeded 60 mm by echocardiography. According to this criteria, the 39 patients were divided into two groups: 18 patients of GLA group and 21 of non-GLA group. Eight GLA (44%) and 11 non-GLA patients (52%) needed postoperative respiratory care with intratracheal intubation for more than 24 hours. Four GLA (22%) and 2 non-GLA patients (9.5%) needed reintubation. There was no significant difference between the two groups concerning the duration of postoperative respiratory care and the frequency of reintubation. The reintubated patients had three prominent preoperative clinical profiles, such as poor general condition, poor cardiac function and poor respiratory function. Consequently, it is concluded that in mitral valve disease with a GLA the prolongation of postoperative respiratory care is largely due to poor cardiac and respiratory function rather than to the compression to the bronchus by a GLA.