Intramural Left Atrial Hematoma After Aortocoronary Artery Surgery

Musat, Iulian; Hieber, Cornelia; Kepka, Anton; Novotny, Petrus; Poslussny, Peter; Schwarz, Sebastian; Fitzgerald, Robert D.

doi:10.1213/01.ane.0000085641.90506.70

Cited by 15 publications

(8 citation statements)

References 6 publications

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“…LA dissection is an uncommon finding that occurs most often after mitral valve (MV) surgery, [1][2][3][4][5] though it has also been reported after aortic valve surgery, coronary artery bypass grafting, radiofrequency arrhythmia ablation, and pulmonary vein cannulation. [6][7][8][9][10] The differential diagnosis includes any obstructive pathology of the MV including thrombus, intracardiac tumor, coronary aneurysm, and pericardial effusion or cyst (though any of these should be evident on TEE examination prior to institution of CPB). Management of this complication is generally surgical due to the potential for hemodynamic compromise.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Dissection after Left Ventricular Aneurysm Repair

Pisklak¹,

Tolpin²,

Youngblood³

et al. 2012

Echocardiography

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Left atrial (LA) dissection is an uncommon entity that occurs most often after mitral valve surgery. We present a case of a 52-year-old man who developed an LA dissection after repair of a postinfarction left ventricular (LV) aneurysm. Transesophageal echocardiography was used to establish the diagnosis of an LA dissection that almost completely occluded the LA, limiting LV filling and causing hemodynamic instability.

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Section: Discussionmentioning

confidence: 99%

Left Atrial Dissection after Left Ventricular Aneurysm Repair

Pisklak¹,

Tolpin²,

Youngblood³

et al. 2012

Echocardiography

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“…Intramural left atrial hematomas are a very uncommon entity, but have been described to occur spontaneously [1-4], after aortocoronary bypass surgery [5], after percutaneous coronary interventions [6,7], radiofrequency catheter ablations [8,9] and after blunt chest trauma [10]. …”

Section: Discussionmentioning

confidence: 99%

Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement - case report

Bruegger

Sadoni

Primaychenko

et al. 2011

J Cardiothorac Surg

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Left atrial intramural hematoma is a seldom cause of left atrial mass. It has been described to occur spontaneously, after interventional procedures, after blunt chest trauma, or after aortocoronary bypass surgery. We present a case of mitral valve replacement together with the removal of a large intraatrial space-occupying lesion. Intraoperative transesophageal echocardiography confirmed a successful resection of this mass. Surprisingly, upon admission to ICU, transesophageal and transthoracic echocardiography revealed a recurrence of an intramural lesion, closest matching a hematoma, which was confirmed by contrast-enhanced computed tomography. Surgical intervention was thoroughly discussed but a conservative management was favoured. 3 months after surgery, a reassessed transthoracic echocardiography and computed tomography demonstrated an almost complete resolution of the pre-existing hematoma.

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“…Three patients had both mitral and aortic valve surgery [1,12,14]. Of 16 patients with CAD, 7 patients (43.8 %) had PCI [38][39][40][41][42][43], 5 (31.3 %) had CABG [2,[44][45][46][47], and 4 had no procedure [1,[48][49][50]. PCI was performed to the left circumflex artery in 4 patients and to …”

Section: Procedures Performed Before Onset Of La Dissectionmentioning

confidence: 99%

“…The technique for surgical repair is not yet established. There are two types of surgical treatment, including entry closure [2, 3, 5, 8-11, 16, 26, 33, 47, 54, 55, 57] and internal drainage [27,28,46,48,58,62]. Genoni reported internal drainage of an LA wall into the right atrium.…”

Section: Treatmentmentioning

confidence: 99%

Left atrial dissection

Tsukui

Iwasa

Yamazaki

2015

Gen Thorac Cardiovasc Surg

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Left atrial (LA) dissection is a rare complication and is defined as a gap from the mitral or tricuspid annular area to the interatrial septum or left atrial wall. Because of its low incidence, this entity is not fully understood. LA dissection is related to mitral valve surgery as well as coronary artery disease, arrhythmia, trauma, tumor, and spontaneous occurrence. Transesophageal echocardiography is the most useful diagnostic modality for LA dissection, but multimodality investigation supports accurate diagnosis. There are two treatment options for LA dissection: surgical repair and close observation. Surgical repair involves entry closure and internal drainage. The indication for surgery should be based on the clinical presentation.

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Intramural Left Atrial Hematoma After Aortocoronary Artery Surgery

Abstract: The authors report the utility of transesophageal echocardiography for diagnosis and management of an intramural left atrial hematoma during coronary artery surgery.

Cited by 15 publications

References 6 publications

Left Atrial Dissection after Left Ventricular Aneurysm Repair

Left Atrial Dissection after Left Ventricular Aneurysm Repair

Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement - case report

Left atrial dissection

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