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J Anesth. 2013 Oct;27(5):699-704. doi: 10.1007/s00540-013-1594-8. Epub 2013 Mar 19.

Preoperative left atrial volume index predicts postoperative atrial fibrillation in patients with severe aortic valve stenosis.

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Department of Anesthesiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan,



Left atrial enlargement correlates with the severity of diastolic dysfunction and is a predictor of cardiovascular complications such as atrial fibrillation. Aortic valve stenosis (AS) causes left atrial enlargement and progression of diastolic dysfunction. The aim of this study was to investigate the efficacy of the preoperative left atrial volume index (LAVI) in predicting postoperative outcome in patients with severe AS.


Forty-seven patients with severe AS who underwent aortic valve replacement were examined. Transthoracic echocardiography and LAVI measurement were performed on admission. Patients were divided into two groups according to optimal cut-off values of LAVI derived from receiver operating characteristic curves for postoperative atrial fibrillation (POAF) (group S: LAVI <52 ml/m(2), group L: LAVI ≥52 ml/m(2)). The incidence of POAF, ventilation time, inotropic support time, duration of stay in intensive care, and overall duration of hospital stay were evaluated.


By univariate analysis, the incidence of POAF in group S was significantly lower than that in group L (25.9 and 65.0%, respectively; P < 0.01). Values for other parameters were higher in group L, although the differences were insignificant.


In patients with severe AS, a preoperative LAVI of ≥52 ml/m(2) may be a useful predictor of POAF, although the efficacy of this index for predicting other postoperative outcomes has yet to be determined.

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