title: [Atrial wall hematoma after mitral valvuloplasty and maze procedure: a case report].
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Japanese Red Cross Medical Center, Hiroo 4-1-22, Shibuya-ku, Tokyo 150-8935.
authors.forename: Ayuko
authors.initials: A
authors.lastname: Shimozato
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Myoue
authors.initials: M
authors.lastname: Kim
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Oguri
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yonemura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Uozumi
authors.forename: Naoshi
authors.initials: N
authors.lastname: Kobayakawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Masuzawa
authors.forename: Jotaro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Aoyagi
mesh_terms: 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