Echocardiographic features of left atrial dissection.
OBJECTIVE
To study left atrial dissection, a rare complication of mitral valve replacement.


RESULTS
From our hospital database of 5497 transoesophageal echocardiograms, we analysed 524 echocardiograms performed on 478 patients with mitral valve prosthesis. We found four patients (0.84%) with left atrial dissection diagnosed by transoesophageal echocardiography that visualized the left atrial dissection: in three patients the diagnosis was confirmed intraoperatively. Three patients had previously had replacements of the mitral valve. Left atrial dissection was a severe complication: one patient died and the two patients successfully operated on had paraprosthetic regurgitation.


CONCLUSIONS
Transoesophageal echocardiography is the first choice for diagnosis of left atrial dissection, a rare complication of mitral valve replacement with an acute/subacute clinical course. Previous mitral valve replacement seems to be the main risk factor to develop left atrial dissection.
Martinez-Sellés
M
M
Hospital Universitario Gregorio Marañon, Madrid, Spain.
García-Fernandez
M A
MA
Moreno
M
M
Bermejo
J
J
Delcán
J L
JL
D000368:Aged; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006341:Heart Rupture / Q000000981:diagnostic imaging* / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011475:Prosthesis Failure