[Atrial wall hematoma after mitral valvuloplasty and maze procedure: a case report].
A 66-year-old male patient with mitral regurgitation and atrial fibrillation underwent mitral valvuloplasty with a modified maze procedure. Follow-up echocardiography performed on the 4th postoperative day revealed a high echoic mass of 6.7 x 3.0 cm which appeared continuous to the left atrial wall and protruded into the left atrial cavity. The irregular surface of the mass echo was not compatible with atrial wall hematoma, so computed tomography (CT) was performed for the differential diagnosis. CT showed extension of the mass from the left atrium to the interatrial septum and right atrium, which lead to a conclusive diagnosis of atrial wall hematoma. Echocardiography showed the hematoma was diminished and eventually disappeared after simply reducing the warfarinization level. This rare case of atrial wall hematoma, especially after the maze procedure, required differential diagnosis from intraatrial thrombus and atrial wall dissection.
Shimozato
Ayuko
A
Department of Cardiovascular Medicine, Japanese Red Cross Medical Center, Hiroo 4-1-22, Shibuya-ku, Tokyo 150-8935.
Kaneko
Yukihiro
Y
Kim
Myoue
M
Takeuchi
Hiroaki
H
Oguri
Atsushi
A
Yonemura
Shigeto
S
Uozumi
Hiroki
H
Kobayakawa
Naoshi
N
Masuzawa
Akihiro
A
Kobayashi
Jotaro
J
Aoyagi
Teruhiko
T
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery; D006348:Cardiac Surgical Procedures; D003937:Diagnosis, Differential; D004452:Echocardiography; D006325:Heart Atria; D006331:Heart Diseases / Q000175:diagnosis*; D006406:Hematoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis*; D013927:Thrombosis; D014057:Tomography, X-Ray Computed