title: Intramural hematoma and oozing rupture of left atrium after resection of wide-based left atrial myxoma.
abstract: We describe a rare complication after the resection of the left atrial (LA) myxoma. After tumor resection, a large defect of the endocardium was reinforced with an autologous pericardial patch. Transesophageal echocardiography demonstrated a hematoma and pulsatile flow beneath the patch, without patch perforation or detachment. Bleeding increased after closure of the sternum. Intramural hematoma and oozing rupture of the LA were diagnosed. A small intramural vessel of the LA was identified as the main causative site of bleeding. The pericardial patch was repositioned with fibrin glue. Fibrin sheets and glue were applied for reinforcement of the LA from outside.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Ohira
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Doi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Maeda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006338:Heart Neoplasms / Q000601:surgery*; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000628:therapy; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D009232:Myxoma / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012422:Rupture, Spontaneous
chemical_list: D015718:Fibrin Tissue Adhesive
keywords: left atrial myxoma; rupture; tumor