Left atrial dissection

Abstract

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.

Left atrial dissection: A rare entity

“…Other causes include blunt chest trauma, acute myocardial infarction, invasive cardiac procedures, and infective endocarditis . Dissection formation between endocardium and epicardium of the left atrium develops secondary to blood entering through a necrotic tissue between the layers, forming a tract . It is described as a gap from the mitral or tricuspid annular area to the interatrial septum or left atrial wall .…”

“…2,3 Dissection formation between endocardium and epicardium of the left atrium develops secondary to blood entering through a necrotic tissue between the layers, forming a tract. 4,5 It is described as a gap from the mitral or tricuspid annular area to the interatrial septum or left atrial wall. 2 Left atrial dissections are most frequently seen on the posterior wall of the left atrium because the attachment of the posterior leaflet to the annulus is mainly muscular with little fibrous tissue.…”

A Rare Cause of Left Ventricular Assist Device (LVAD) Obstruction: Left Atrial Dissection

“…Based on the review of the available literature, all of intraoperative left atrial wall dissections should be repaired. Acute, left atrial wall dissections resulting in mitral valve inflow obstruction require repair; and delayed left atrial wall dissection in a stable patient can be managed conservatively [ 1 , 4 , 8 ] .…”

Left ventricular basal inferior pseudoaneurysm and left atrial dissection after myocardial infarction: Case report

“…2 Other predisposing factors include percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), arrhythmia catheter ablation, and trauma. [1][2][3][4][5] Due to the rarity of this entity, incomplete understanding of its pathophysiology, and absence of guidelines to manage treatment, 6 the authors present a case of left atrial dissection after myocardial infarction. [1][2][3][4][5] Due to the rarity of this entity, incomplete understanding of its pathophysiology, and absence of guidelines to manage treatment, 6 the authors present a case of left atrial dissection after myocardial infarction.…”

“…1 A recent literature review found 89 reported cases, being the majority (47 cases) associated with mitral valve replacement surgery. 2 Other predisposing factors include percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), arrhythmia catheter ablation, and trauma. 2 There were only four cases described of left atrial dissection after acute myocardial infarction in patients who did not undergo PCI or CABG.…”