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Ann Thorac Surg 1999;68:1394-1396
© 1999 The Society of Thoracic Surgeons


Case Reports

Treatment of left atrial dissection after mitral repair: internal drainage

Michele Genoni, MDa, Rolf Jenni, MDb, Edith R. Schmid, MDc, Paul R. Vogt, MDa, Marko I. Turina, MDa

a Clinic for Cardiac Surgery, Zurich, Switzerland
b Division of Echocardiography, Zurich, Switzerland
c Division of Cardiovascular Anesthesia, University Hospital Zurich, Zurich, Switzerland

Adress reprint requests to Dr Genoni, Clinic for Cardiac Surgery, University Hospital, CH-8091 Zurich, Switzerland

Two patients with intraoperative dissection of the entire left atrium after mitral valve repair are presented. Intraoperative transesophageal echocardiography detected left atrial dissection with formation of a large cavity compressing the left atrium. The false lumen was opened and widely connected to the right atrium to perform the decompression. This technique permits the runoff into the low pressure system in case of persisting hemorrhage from the unknown entry, and eliminates the risk of systemic embolization from the cavity.




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