Korean J Anesthesiol.  2004 Apr;46(4):489-492. 10.4097/kjae.2004.46.4.489.

Left Atrial Dissection by Aorto-Left Atrial Fistula after Aortic Valve Replacement: A case report

• Shin IW
• Ok SH
• Sohn JT
• Lee HK
• Chung YK

• KMID: 2299064
• DOI: http://doi.org/10.4097/kjae.2004.46.4.489

Abstract

Left atrial dissection is an uncommon entity, and is generally associated with mitral valve surgery, blunt chest trauma, intramyocardial dissecting hematoma after AMI, Behcet's disease, and infective endocarditis. Moreover, debridement of very calcified valves or inadvertent incision of the annulus may occur during the surgical procedure, and hemodynamic influence of a paraprosthetic leak may extend the dissection into the left atrial wall. We report a case with a mobile intimal flap of the left atrial wall detected by intraoperative transesophageal echocardiography after aortic valve replacement. An intraoperative transesophageal echocardiographic examination is needed for aortic valve replacement, especially when aortic stenosis is combined with severe annulus calcification.

Keyword

aortic stenosis; aortic valve replacement; left atrial dissection; transesophageal echocardiography

MeSH Terms

Aortic Valve Stenosis
Aortic Valve*
Debridement
Echocardiography
Echocardiography, Transesophageal
Endocarditis
Fistula*
Hematoma
Hemodynamics
Mitral Valve
Thorax