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J Thorac Cardiovasc Surg 2003;126:604-605
© 2003 The American Association for Thoracic Surgery

Brief communication

Left atrial dissection after aortic valve replacement

Hiroshi Osawa, MD, PhDa,*, Shinpei Yoshii, MD, PhDa, Shigeru Hosaka, MD, PhDa, Shoji Suzuki, MD, PhDa, Samuel J. K. Abraham, MD, PhDa, Yusuke Tada, MD, PhDa

a From the Second Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan

Received for publication February 25, 2003; accepted for publication March 6, 2003.

* Address for reprints: Hiroshi Osawa, MD, PhD, Kofu Jonan Hospital, Division of Cardiothoracic Surgery, Kamimachi 753-1, Kofu, Yamanashi, Japan.

Key Words: 18 • 35

The first 20% of the full text of this article appears below.


Dr Osawa


Left atrial dissection is a severe but rare complication occurring in 0.84% of mitral replacement cases.1 We report a case of left atrial dissection caused by aortic annular disruption after aortic valve replacement that was identified by means of transesophageal echocardiography and repaired immediately. Such a case has not been reported in the literature to our knowledge.

Clinical summary

A 73-year-old woman underwent aortic valve replacement for aortic stenosis and concomitant coronary artery bypass grafting. Cardiopulmonary bypass was performed with moderate hypothermia and cardioplegic arrest. The left internal thoracic artery was anastomosed to the left anterior descending artery, and a saphenous vein graft was anastomosed to a branch of the obtuse marginal artery. After distal coronary bypass, an aortotomy was made. The aortic valve was found to be calcified, and the calcification extended to the aortic annulus. While removing the calcification, a dissection of the noncoronary annulus occurred and was repaired with everted mattress sutures, with which the prosthetic valve was also fixed. Then a . . . [Full Text of this Article]




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