Left Atrial Dissection Secondary to Retrograde Coronary Sinus Cannulation During a Stanford Acute Type-A Aortic Dissection Repair: A Case Report

Abstract

Left atrial (LA) dissections are rare phenomena, often iatrogenic, caused by blood flow into a false lumen, potentially obstructing the pulmonary veins or flow into the left ventricle. Severity can range from an incidental observation or complete circulatory collapse. While LA dissections are often associated with mitral valve repair, there are 2 reported cases of LA dissections associated with retrograde cardioplegia cannula insertion through the coronary sinus. Here, we present a large LA dissection that was directly visualized and tracked to a coronary sinus injury from the retrograde cardioplegia cannula. The clinical presentation and echocardiography findings informed our subsequent management.

Left Atrial Dissection Induced by Coronary Sinus Catheter-Related Injury

“…Previous reports documented successful outcomes with conservative management in 3 patients with LA dissection. 3 , 4 , 5 Our case emphasizes the necessity of timely intervention for rapid LA dissection progression.…”

“…The incidence of LA dissection induced by to CSCRI is low (ranges from 0.053% to 0.093%), 2 but it may be underestimated. In a literature search of the PubMed, only 5 reported cases of LA dissection related to CSCRI were found 3 , 4 , 5 , 6 , 7 ( Table 1 ).…”

“…In a literature search of the PubMed, only 5 reported cases of LA dissection related to CSCRI were found 3 , 4 , 5 , 6 , 7 ( Table 1 ).…”