Left Atrial Dissection: An Unusual Complication of Mitral Valve Surgery

Abstract

Left atrial (LA) dissection is an uncommon complication of mitral valve surgery. We report a case of a patient found to have left atrial dissection two months after mitral valve repair. In brief, we also review etiology, presentation, and management of LAD.

Intramural Hematoma and Oozing Rupture of Left Atrium after Resection of Wide‐Based Left Atrial Myxoma

“…LA dissection was reported as one of the rare complications of mitral valve surgery . LA dissection leads to a large cavity between the LA endocardium and myocardium.…”

“…LA dissection leads to a large cavity between the LA endocardium and myocardium. Most patients with LA dissection have been diagnosed with TEE following mitral surgery . The timing of the presentation of LA dissection is variable, ranging from hours to years after surgery .…”

“…Dissection of the left atrium (LA) is commonly known as a rare complication of the mitral procedure . We herein describe a similar entity of LA dissection and oozing rupture developing after resection of a wide‐based LA myxoma, which was clearly demonstrated by intraoperative transesophageal echocardiography (TEE).…”

Left Atrial Dissection after Left Ventricular Aneurysm Repair

“…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).…”

Left atrial dissection

“…Forty-seven patients had mitral valve surgery including MVR in 36 (76.6 %) (mechanical prosthesis: 28 [1][2][3][7][8][9][10][11][12][13][14][15][16][17][18][19][20], bioprosthesis: 8 [1,2,5,[21][22][23][24][25], unknown: 1 [26]), mitral valve repair in 10 (21.3 %) [1,2,6,[27][28][29][30][31][32], and MVR after failure of repair in 1 (2.1 %) [33]. Of 37 patients who underwent MVR, 11 (29.7 %) had redo MVR [3, 5, 7-9, 11, 16, 18-20].…”