title: Management of a left atrial intramural hematoma after percutaneous intervention.
abstract: Left atrial intramural hematoma is a rare complication of percutaneous intervention. We report the case of a 69-year-old man with recurrent angina after CABG 19 years ago who was admitted for percutaneous intervention. After an attempt to recanalize the native circumflex artery and the vein graft, he had a cardiac arrest and was resuscitated successfully. Transesophageal echocardiography showed a large expanding hematoma within the left atrial wall causing obstruction of the mitral valve and compressing the right atrium from across the septum. An emergency thoracotomy was performed and with transesophageal echocardiography guidance and left atrial intramural hematoma was drained successfully.
authors.affiliation: Cardiothoracic Department, Royal Brompton Hospital, Imperial College, London, United Kingdom.
authors.forename: Anand
authors.initials: A
authors.lastname: Jothidasan
authors.affiliation: Cardiothoracic Department, Royal Brompton Hospital, Imperial College, London, United Kingdom. Electronic address: saina.attaran@nhs.net.
authors.forename: Saina
authors.initials: S
authors.lastname: Attaran
authors.affiliation: Intensive Care Unit, Royal Brompton Hospital, Imperial College, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Hunter
authors.affiliation: Cardiothoracic Department, Royal Brompton Hospital, Imperial College, London, United Kingdom.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: de Souza
mesh_terms: D000368:Aged; D017548:Echocardiography, Transesophageal; D006325:Heart Atria; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*