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Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement--case report.


ABSTRACT: Left atrial intramural hematoma is a seldom cause of left atrial mass. It has been described to occur spontaneously, after interventional procedures, after blunt chest trauma, or after aortocoronary bypass surgery. We present a case of mitral valve replacement together with the removal of a large intraatrial space-occupying lesion. Intraoperative transesophageal echocardiography confirmed a successful resection of this mass. Surprisingly, upon admission to ICU, transesophageal and transthoracic echocardiography revealed a recurrence of an intramural lesion, closest matching a hematoma, which was confirmed by contrast-enhanced computed tomography. Surgical intervention was thoroughly discussed but a conservative management was favoured. 3 months after surgery, a reassessed transthoracic echocardiography and computed tomography demonstrated an almost complete resolution of the pre-existing hematoma.

SUBMITTER: Bruegger D 

PROVIDER: S-EPMC3082235 | biostudies-literature | 2011 Apr

REPOSITORIES: biostudies-literature

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Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement--case report.

Bruegger Dirk D   Sadoni Sebastian S   Primaychenko Mikhail M   Sodian Ralf R   Schmitz Christoph C   Reichart Bruno B   Chappell Daniel D  

Journal of cardiothoracic surgery 20110413


Left atrial intramural hematoma is a seldom cause of left atrial mass. It has been described to occur spontaneously, after interventional procedures, after blunt chest trauma, or after aortocoronary bypass surgery. We present a case of mitral valve replacement together with the removal of a large intraatrial space-occupying lesion. Intraoperative transesophageal echocardiography confirmed a successful resection of this mass. Surprisingly, upon admission to ICU, transesophageal and transthoracic  ...[more]

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