The Long-Term Effect of Successful Mitral Balloon Valvotomy on Left Atrial Size Miltiadis A. Stefadouros MD, Mohammed E. Fawzy FRCP, S. Malik MRCP, Vasudevan Sivanandam MRCP, Layth Mimish FRCP, Zohair Al-Halees MD In order to determine the extent of long-term regression of left atrial (LA) enlargement after successful mitral balloon valvotomy, data obtained from 205 patients before, and at a mean of 31.0 ± 21.1 months (range: 6.0 to 86.3 months) after, valvotomy were analyzed. In response to valvotomy the mitral valve area increased from 0.81 ± 0.27 cm2 at baseline to 1.88 ± 0.45 cm2 at follow up (p<0.0001). Similar significant (p <0.001) reductions were also noted in echocardiographic anteroposterior, superior-inferior and medial-lateral LA dimensions by 13%, 13% and 14% respectively, and in calculated LA volume by 34%. Patients in atrial fibrillation had larger LA dimensions, but substantially smaller absolute and relative reduction in LA size at follow up than patients in sinus rhythm. Normalization in anteroposterior LA dimension at follow up was seen in 29% of patients in sinus rhythm, but in none of 32 patients with atrial fibrillation.

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