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A Rare Case of Mitral Prosthesis Dislocation Due to a Circumferential Left Atrial Dissection.

ABSTRACT: Left atrial dissection is a rare entity mostly associated with mitral valve surgery and revealed in early post-operative period. This case report discusses a case of left atrial dissection associated with dislocation of the mechanical mitral prosthesis in the left atrium, which was peculiar in its anatomy and pathophysiology, occurred 12 years after surgery. (Level of Difficulty: Advanced.).

SUBMITTER: De Michele L

PROVIDER: S-EPMC8302772 | biostudies-literature |

REPOSITORIES: biostudies-literature

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A case of left atrial dissection after mitral valve replacement.

Project description:Left atrial dissection (LatD) is a rare complication of cardiac surgery due to creation of a false chamber through a tear in the mitral valve annulus that extends into the left atrium wall. It is primarily associated with mitral valve surgery although other etiologies have also been defined. Perioperative transesophageal echocardiography (TEE) is a key to the diagnosis. This is a case report of management of LatD after mitral valve replacement.

| S-EPMC6078022 | biostudies-literature

Left atrial endocarditis as a rare complication of mitral valve endocarditis: a clinical case.

Project description:BackgroundInfective Endocarditis (IE) is considered as a multifaceted problem in every aspect from etiology and presentation to diagnosis and management. Early recognition of this disease and especially its complications, remain a critical task for the cardiologist. Atrial endocarditis is a rare and sometimes unrecognized complication of mitral valve endocarditis.Case presentationWe present a 48 year-old male patient who was admitted to our clinic because of recent onset of malaise, fever, jaundice and peripheral edema. Important physical findings were peripheral stigmata of IE in addition to holosystolic murmur over the left sternal border. Transthoracic and transesophageal echocardiophy revealed a severe eccentric MR due to a flailed posterior mitral valve caused by IE. The presence of atrial septal endocarditis caused by jet streaming was also observed. Blood culture was positive for streptococcus oralis and antibiotic therapy was immediately initiated. Considering the large burden of infective tissue, the patient was planned for an early surgical intervention. A minimally invasive resection of the atrial mass, direct closure of the defect, resection of the diseased portions of mitral leaflets and implantation of a biological mitral valve prosthesis was performed. Intra-operative and histological findings confirmed provisional diagnosis by echocardiography.ConclusionsTogether with comprehensive echocardiographic evaluation, attention should be placed on mural vegetations and excluded among all cases of mitral valve endocarditis, particularly those with severe eccentric regurgitant jets.

| S-EPMC3507814 | biostudies-literature

Hybrid mics mitral valve replacement with TAVR prosthesis in incomplete circumferential mitral annulus calcification.

Project description: Not available

| S-EPMC10439705 | biostudies-literature

Left atrial wall dissection: a rare sequela of native-valve endocarditis.

Project description:Left atrial wall dissection is a rare condition; most cases are iatrogenic after mitral valve surgery. A few have been reported as sequelae of blunt chest trauma, acute myocardial infarction, and invasive cardiac procedures. On occasion, infective endocarditis causes left atrial wall dissection. We report a highly unusual case in which a 41-year-old man presented with native mitral valve infective endocarditis that had caused left atrial free-wall dissection. Although our patient died within an hour of presentation, we obtained what we consider to be a definitive diagnosis of a rare sequela, documented by transthoracic and transesophageal echocardiography.

| S-EPMC4382891 | biostudies-other

Intimal Sarcoma: An Extremely Rare Case of a Left Atrial Tumor with Partial Obstruction of the Mitral Orifice.

Project description: Not available

| S-EPMC8071820 | biostudies-literature

An Extremely Rare Cause of Mitral Regurgitation—Accessory Commissural Mitral Tissue with Anomalous Left Atrial Chordal Attachment.

Project description:Highlights•Accessory mitral tissue and left atrial chordae are rare congenital abnormalities.•Accessory mitral tissue can result in left ventricular outflow tract and mitral valve obstruction.•This is the first case of lateral mitral accessory tissue with an associate anomalous chord.•Transthoracic echocardiography may not be able to evaluate accessory mitral valve tissue.•Removal of anomalous chordae affecting the mitral valve may be complicated.

| S-EPMC6833125 | biostudies-other

Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement--case report.

Project description:Left atrial intramural hematoma is a seldom cause of left atrial mass. It has been described to occur spontaneously, after interventional procedures, after blunt chest trauma, or after aortocoronary bypass surgery. We present a case of mitral valve replacement together with the removal of a large intraatrial space-occupying lesion. Intraoperative transesophageal echocardiography confirmed a successful resection of this mass. Surprisingly, upon admission to ICU, transesophageal and transthoracic echocardiography revealed a recurrence of an intramural lesion, closest matching a hematoma, which was confirmed by contrast-enhanced computed tomography. Surgical intervention was thoroughly discussed but a conservative management was favoured. 3 months after surgery, a reassessed transthoracic echocardiography and computed tomography demonstrated an almost complete resolution of the pre-existing hematoma.

| S-EPMC3082235 | biostudies-literature

Takotsubo syndrome complicated by cardiogenic shock due to left ventricular outflow tract obstruction, acute mitral regurgitation, and atrial fibrillation: a case report.

Project description:BackgroundAlthough Takotsubo syndrome (TTS) is generally considered a benign disease, recent reports showed the incidence of cardiogenic shock due to left ventricular outflow tract obstruction (LVOTO), mitral regurgitation (MR), and primary pump failure was estimated to be 6-20%.Case summaryA 78-year-old woman presented with chest pain and cold sweats 2 days after surgery for lung cancer. Acute coronary syndrome was suspected based on her symptoms, electrocardiography, transthoracic echocardiography (TTE), and laboratory data; thus, emergency catheterization was performed. Normal coronaries were observed, with hyperkinesis at the base of the left ventricle and akinesis at its apex, leading to the diagnosis of the apical ballooning type of TTS. Pressure differences between the apex of the left ventricle (168/8/28 mmHg) and aorta (94/50/64 mmHg) indicated the presence of LVOTO. Two days after TTS onset, she developed cardiogenic shock (blood pressure was 54/38 mmHg). Transthoracic echocardiography showed acute MR due to systolic anterior motion of the mitral valve caused by LVOTO, which was further exacerbated by paroxysmal atrial fibrillation. Fluid resuscitation, intravenous β-blockers, and amiodarone were administered for reduction of the pressure gradient in the left ventricular outflow, rate control, and sinus rhythm maintenance. Her condition improved along with the MR, thereby improving LVOTO and maintaining sinus rhythm.DiscussionTakotsubo syndrome should be kept in mind as a potential cause of acute MR due to LVOTO. Catheterization and multiple follow-up TTE play a major role in early detection for this condition.

| S-EPMC11319876 | biostudies-literature

Mitral Annular Kinetics, Left Atrial, and Left Ventricular Diastolic Function Post Mitral Valve Repair in Degenerative Mitral Regurgitation.

Project description:ObjectiveThe relationship of mitral annular (MA) kinetics to left ventricular (LV) and left atrial (LA) function before and after mitral valve (MV) repair has not been well studied. Here we sought to provide comprehensive analysis that relates to MA motions, and LA and LV diastolic function post MV repair.MethodsThree-dimensional analyses of mitral annular motion, LA function, and LV volumetric and diastolic strain rates were performed on 35 degenerative mitral regurgitation (MR) patients at baseline and 1-year post MV repair, and 51 normal controls, utilizing cardiac magnetic resonance imaging with tissue tagging.ResultsAll had normal LV ejection fraction (EF) at baseline. LV and LA EFs decreased 1-year post-surgery vs. controls. LV early diastolic myocardial strain rates decreased post-surgery along with decreases in normalized early diastolic filling rate, E/A ratio, and early diastolic MA relaxation rates. Post-surgical LA late active kick remained higher in MR patients vs. control. LV and LA EFs were significantly associated with peak MA centroid to apex shortening. Furthermore, during LV systolic phase, peak LV ejection and LA filling rates were significantly correlated with peak MA centroid to apex shortening rate, respectively. While during LV diastolic phase, both peak early diastolic MA centroid to apex relaxation rate and LA ejection rate were positively significantly associated with LV peak early diastolic filling rate.ConclusionMA motion is significantly associated with LA and LV function. Mitral annular motion, left atrial function, and LV diastolic strain rates are still impaired 1 year post MV repair. Long-term effects of these impairments should be prospectively evaluated.

| S-EPMC4671359 | biostudies-literature

Left Atrial Myxomectomy with Intraoperative Severe Mitral Regurgitation and Complicated Postoperative Course - Case Report.

Project description:Primary cardiac tumors are a rare occurrence with myxomas accounting for about half of the benign tumors. Once diagnosed, surgical resection is the standard of care. Our case describes a female in her 50s who underwent a myxoma resection under cardiopulmonary bypass via biatrial approach. Intraoperatively, the thin septal crux between the wall of the aorta and mitral valve was damaged during resection, requiring stem cell tissue matrix for repair. The patient also developed severe mitral regurgitation suggesting infarct to the left coronary system during resection, subsequently receiving a mechanical mitral valve and a saphenous vein bypass graft. Postoperatively, she developed atrial fibrillation with a left atrial appendage thrombus, heart failure with an ejection fraction of 30%-35%, and a transient ischemic attack. In conclusion, it is important for the clinician to appreciate the possible complications of resection peri and postoperatively.

| S-EPMC5123616 | biostudies-literature

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