Conservative management of a rare case of atrial septal hematoma after pediatric cardiac surgery

Abstract

Atrial septal hematoma is uncommon complication that may happen after any cardiac intervention. Although it is rare, it can pose a challenging situation in the postoperative care. Multiple management approaches has been described with different outcomes. Here we are reporting a boy, aged 13 years, with dilated aortic root who underwent aortic root replacement with valve preservation. Postoperative course was complicated by atrial septal hematoma. A nonsurgical management approach was chosen based on the patient clinical condition. Regression in size with complete resolution of the hematoma was observed during the follow up.

An unusual intraoperative finding: Left atrial dissecting intramural hematoma after aortic root replacement

“…They are rare complications that can be found after valve surgery, percutaneous cardiac procedures, cardiopulmonary resuscitation, or spontaneously. 1 , 2 , 3 , 4 Anatomically, the division of the noncoronary aortic annulus allows entry into the LA wall. A failed attempt of aortic valve–sparing surgery and AVR may cause aortic annular disruption, which might result in atrial wall dissection and contained hematoma.…”

“… 2 , 5 , 6 Many cases of benign course of LA intramural hematoma with conservative treatment have been reported. 3 , 7 …”