Abstract
An 85-year-old woman with long-standing atrial fibrillation and severe tricuspid regurgitation presented with worsening symptoms and massive right atrial enlargement (RAE). The patient experienced shortness of breath even during minimal exertion, such as walking within her house, which significantly impacted her daily activities. Surgical intervention, including tricuspid valve replacement and right atrial plication (RAP), led to significant symptomatic relief and improved pulmonary function. Postoperatively, the patient's heart size and lung capacity showed significant recovery. This case underscores the potential benefits of the RAP in alleviating respiratory restriction due to lung compression caused by the enlarged right atrium and enhancing the quality of life of patients with severe RAE.