Left atrial dissection after a supra-annular mitral valve replacement for endocarditis

Left atrial dissection after a supra-annular mitral valve replacement for endocarditis

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Abstract Background Left atrial dissection is a rare and a potentially fatal complication of cardiac surgery.Multi-modal imagery is helpful for the diagnosis and to guide the treatment.Case presentation We report the case of a 66-year-old female patient who underwent a combined mitral and aortic valve grateful dead silicone mold replacement for degenerative valvular disease.

She presented an infectious endocarditis revealed by a third-degree atrioventricular bloc and had a redo mitral- and aortic valve replacement.Mitral valve was inserted in supra-annular position due to annular destruction.Post-operative course was marked by a refractory acute heart failure explained by a nike dunk high crimson tint left atrial wall dissection confirmed by transoesophageal echocardiography and synchronized cardiac CT-scan.

Surgical treatment was theoretically indicated but considering the high risk of a third surgery, a palliative care support was collegially decided.Conclusions Left atrial dissection can occur after a redo surgery and supra-annular mitral valve implantation.Multi-modal imagery including transoesophageal echocardiography and cardiac CT-scan is helpful for the diagnosis.