Fig. 3

The Radiological examinations of a patient with GLA and right lateral protrusion. Pre- (a) and postoperative (b) AP X-ray images of the cardiac silhouette of a 65-year-old woman with severe mitral regurgitation, pulmonary hypertension, tricuspid regurgitation and dilation of the left atrium (LA area, 81 cm² and a cardiothoracic ratio of 0.8). Red arrows point to the right heart border (a and b). Heart auto-transplantation was performed to replace the mitral valve with a biological prosthesis (yellow arrow) (St. Jude Medical, 27 mm). Excess atrial tissue was surgically removed followed by LA atrioplasty. Red arrows point to the right-lateral lining of the cardiac silhouette (a and b). The procedure successfully restored normal concave left heart border (b), (LA area, 23 cm² and a cardiothoracic ratio of 0.6). Postoperative echocardiogram displayed a normalised left atrium area (indicated by the dotted line) and other chambers without significant morphological distortions (c)