Giant Left Atruim in Rheumatic Mitral Valve Disease, What Prognosis?

Rheumatic mitral stenosis (MS) remains the most common type of valvular heart disease worldwide. While the prevalence of mitral valve rheumatism is decreasing in industrialized countries, it continues to be endemic in most countries in Asia, Latin America, the Middle East and Africa, including Morocco, which delimits the belt of shame.

Giant left atrium (ectasia of the left atrium) is due to long-term evolution of rheumatic mitral valve disease, approximately 10 years after diagnosis of MS can be really challenging when it comes to therapy decision. Transthoracic echocardiography is first tool used in heart valve evaluation and evaluating heart remodeling during advanced stage valve diseases. The prognosis of patients diagnose lately for rheumatic mitral stenosis with giant left atrium (ectasia) depends largely on some factors especially reversible pulmonary hypertension, possible left atrium reduction (LAR) associated with other comorbidities.

We hereby report cases of 3 female adult patients lately diagnosed for rhematic mitral stenosis with giant (ectasia) left atrium (GLA) and severe pulmonary hypertension who in spite of surgical valve replacement shortly died after surgery because of persistent pulmonary hypertension. What determines their poor prognosis?