Journal Article

Left atrial dissection: an almost unknown entity

Shinichi Fukuhara, Kamellia R. Dimitrova, Charles M. Geller, Darryl M. Hoffman and Robert F. Tranbaugh

in Interactive CardioVascular and Thoracic Surgery

Volume 20, issue 1, pages 96-100
Published in print January 2015 | ISSN: 1569-9293
Published online September 2014 | e-ISSN: 1569-9285 | DOI: http://dx.doi.org/10.1093/icvts/ivu317
Left atrial dissection: an almost unknown entity

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  • Professional Development in Medicine
  • Cardiothoracic Surgery
  • Cardiovascular Medicine
  • Molecular Biology and Genetics
  • Molecular and Cell Biology
  • Research Methods in Life Sciences

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Left atrial dissection is an exceedingly rare but potentially fatal complication of cardiac surgery. It is most commonly associated with mitral valve surgery, including both replacement and repair, with a reported incidence rate of 0.16%. However, other cardiac surgical or catheter-based interventional procedures are also known as potential predisposing factors. The time of presentation from the cause of dissection varies extremely, ranging from immediate occurrence up to 20 years later. The dissection forms a large cavity between the endocardium and epicardium of the left atrium, causing obliteration of the left atrial cavity and resultant haemodynamic compromise, which almost always requires immediate surgical intervention. In contrast, left atrial dissection without haemodynamic instability can often be managed non-operatively with satisfactory outcomes. This article reviews this rare but relevant clinical entity to further elucidate the incidence, pathogenesis, clinical course, management and outcome of left atrial dissection.

Keywords: Left atrial dissection; Mitral valve surgery; Transoesophageal echocardiography

Journal Article.  3638 words. 

Subjects: Professional Development in Medicine ; Cardiothoracic Surgery ; Cardiovascular Medicine ; Molecular Biology and Genetics ; Molecular and Cell Biology ; Research Methods in Life Sciences

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