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Case Reports

Giant Left Atrium Needed Negative Pressure Ventilation

^a Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel
^b Division of Thoracic and Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
^c Division of Cardiovascular Surgery Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
^d Department of Anesthesia, Sheba Medical Center, Ramat Gan, Israel

Accepted for publication March 18, 2009.

^_* Address correspondence to Dr Kachel, Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, 52621, Israel (Email: erezk{at}bezeqint.net).

Giant left atrium (GLA) is seen in a variety of cardiac conditions. The GLA is diagnosed by combining the patient's history, physical examination, and imaging techniques, along with a computed tomographic chest scan, echocardiogram, and barium swallow test. We recently operated on a severely symptomatic 71-year-old woman with GLA (135 mm x 192 mm). We were forced to anesthetize her with negative pressure ventilation before connecting to the cardiopulmonary bypass circuit. Her postoperative course and long-term follow-up were uneventful. The procedure for GLA reduction is safe, even in very high-risk patients. Negative pressure ventilation may be used successfully as a bridge to cardiopulmonary bypass in certain cases.