• J Cardiothorac Surg · Apr 2011

    Case Reports

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

    • Dirk Bruegger, Sebastian Sadoni, Mikhail Primaychenko, Ralf Sodian, Christoph Schmitz, Bruno Reichart, and Daniel Chappell.
    • Department of Anesthesiology, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377 Munich, Germany. dirk.bruegger@med.uni-muenchen.de
    • J Cardiothorac Surg. 2011 Apr 13; 6: 50.

    AbstractLeft 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.

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