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.

TAR is a reasonable surgical technique for Kommerell's diverticulum, because it enables the vascular ring to be completely released, preventing recurrence, rupture, and dissection. Anatomic reconstruction of the SCA was effective to prevent hand ischemia and subclavian steal syndrome.

Low late mortality and a low incidence of valve-related events can be achieved for at least 30 years using mechanical bileaflet valve replacement. Persistent atrial fibrillation is a significant risk factor for morbidity and mortality.

Left atrial dissection (LAD) 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. LAD is related to mitral valve surgery as well as coronary artery disease, arrhythmia, trauma, and tumors, and occurs spontaneously. Transesophageal echocardiography is the most useful diagnostic modality for LAD, but multimodality investigation supports accurate diagnosis. We experienced a case of LAD related to retrograde cardioplegia cannula insertion which was treated successfully with internal drainage.

Folding mitral valve repair is an easily fine-tuned technique with a pilot suture, which can be easily removed and repositioned, if unsatisfactory. This reversibility is a significant advantage of this technique. Long-term follow-up is necessary to assess the durability of this technique.