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J Thorac Cardiovasc Surg 2006;132:152-153
© 2006 The American Association for Thoracic Surgery
Brief Communication |
a Cardiac Surgery, University Federico II, Naples, Italy
b Cardiac Surgery Clinica Pineta Grande, Castelvolturno (CE), Italy
Received for publication March 6, 2006; accepted for publication March 15, 2006. * Address for reprints: Paolo Stassano, MD, Via Bramante, 19, 81100 Caserta, Italy. (Email: pstassano@libero.it).
| The first 20% of the full text of this article appears below. |
Left atrial dissection (LAD) is a rare complication that usually occurs after mitral valve replacement (MVR). It is an insidious complication that can present itself in many aspects that may confuse the clinical picture.
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Clinical Summary
On January 2005 a 64-year-old man was admitted to our hospital for fever. He underwent open mitral commissurotomy in 1980 and an MVR with a 33 Carpentier porcine bioprosthesis in 1995. A transesophageal echocardiogram (TEE) showed vegetation on the bioprosthesis and thrombi in the left atrium. At surgery, thrombi were removed from the left atrium, and the bioprosthesis was excised. At examination the prosthesis revealed vegetation and thrombi on the ventricular side. A 29 St Jude mitral prosthesis (St Jude Medical Inc, St Paul, Minn) was implanted by means of 2-0 Tevdek pledget-reinforced sutures. Intraoperative TEE showed good valve function and no periprosthetic leakage. In the afternoon of the second postoperative day, the patient had intense dyspnea
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