Atrial Intramural Hematoma Research Articles

Left atrial intramural hematoma after a percutaneous coronary intervention detected by transthoracic echocardiogram.

Left atrial intramural hematoma after a percutaneous coronary intervention detected by transthoracic echocardiogram.

Woman With Chest Pain and Dyspnea

A 48-year-old woman presented to the emergency department with 1 day of chest discomfort, dyspnea, and orthopnea. She was discharged from the hospital 2 days ago after radiofrequency catheter ablation for atrial flutter. Her ECG and chest radiography were both normal. Bedside cardiac point-of-care ultrasound showed a large hyperechoic mass in the left atrium (Figure 1, Figure 2, Videos E1 and E2).Figure 2Ultrasonographic apical view demonstrated the hyperechoic mass (arrowhead) occupying most of the left atrial cavity.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Left atrial intramural hematoma post–catheter ablation. Cardiac computed tomography (CT) demonstrated a left atrial intramural hematoma causing compression of the left ventricular inflow tract with a small pericardial effusion (Figure 3). The patient was admitted to the coronary care unit for monitoring and observation; at 4 days, her repeat cardiac CT demonstrated a stable hematoma, and she was discharged after 7 days. At 1 month, her cardiac CT later showed nearly complete resolution. The overall incidence of ablation-related complications has been decreasing over the last few decades as institutions have gained experience and is estimated at 3% although the incidence of left intramural hematoma is far lower.1Gupta A. Perera T. Ganesan A. et al.Complications of catheter ablation of atrial fibrillation: a systematic review.Circ Arrhythm Electrophysiol. 2013; 6: 1082-1088Crossref PubMed Scopus (188) Google Scholar, 2Giudicatti L. King B. Lee F. et al.Left atrial intramural hematoma post-ablation of supraventricular tachycardia: a rare complication treated successfully.JACC Case Rep. 2020; 2: 223-226Crossref PubMed Scopus (2) Google Scholar, 3Haseeb S. Kutyifa V. Left atrial intramural hematoma after radiofrequency catheter ablation: beware of the unexpected.JACC Case Rep. 2020; 2: 227-229Crossref PubMed Scopus (2) Google Scholar Bedside ultrasound is an excellent method to ascertain cardiac and pericardial complications. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiIxMGNkZTUyZjdjMGJhYWUzMjQ5MGM5NGJjYTYzYjBhNyIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc1NzYwNTA0fQ.O-IwG7CyTItrbzjRokj7gIU1Hzxu7dNLt3ApgNoAp9vDpBMfLbEKgpWSk8sYHetH5Vz8WHXqbQ2Cb5ss4AUxggfsnbvgk0JbJyfkCH7qyJs_mP-wTCLwzS1Q24JLTBWQzQVzmb3YjKPAXSYRppC7irO7R1G0L9eWvgTh4CYPzGjHjYnv2SZGDAMs0B5-rwKF39aZX7nFRt2qVGQ1gzziYuZU7BY5WSC-bAXoQgWYkdsxh3rEwPY1IN8h_8YHSsy0G96mAfUj-9g-tlRjDXkNzYSbSTYYk63S5RN2LKLDaPROMI3LmTc3921xvygReltJLzubF18dMY8W8ZXs1VoEEw Download .mp4 (2.58 MB) Help with .mp4 files LAIH video clip ApicaleyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJlMTg0MjJlMWFjNTVlOTkzNWI1ZmI5NGZlOGY4ZGY0MSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc1NzYwNTA0fQ.EB2L0u__X22_jVC7TfUdeOdBiJ54hHMfy-4yLe29r_pmQiuv9u1aPe0vPHZuU6Gta7yZtdjWEv4vM4DVkRUyRfUihNIJp6x7yAEW-u4KvyI_2cHb3rxHPVvJkUmR4OQZepK8wffdyCytPuZoN79dpyFd2u_Clbq5jd5vI-nHfRJjhn4zM5IMBDQvyFUV76g4F1kw3qsR4hxw5sRff8b2xHM8b4MYHfXYg4AGLO8UsxEmtzVLk0EuiZiQKhRcu3UfvK0DzSas9uhkqp1W1COQY-JQOUk3ToqQMMRQZSDR5W9Orz9-lVB4P_CTTeBgyVXSwVAD8wUaYCq3tXqOU9EdTA Download .mp4 (2.87 MB) Help with .mp4 files LAIH video clip PLAX

744 LEFT ATRIAL DISSECTION AFTER MITRACLIP IMPLANTATION: ECHOCARDIOGRAPHIC FEATURES

Abstract Introduction the MitraClip system (MC) is the leading transcatheter technique to treat mitral regurgitation (MR), presenting very low adverse event rates. Left atrial dissection (LAD) is defined as a gap from left atrial wall. Aim we report a case of LAD occurring after MC implantation, treated conservatively, focusing on suggestive echocardiographic features. Materials and methods transthoracic and transesophageal echocardiography with 3D reconstructions were performed. Results the patient was a 73-years-old woman with symptomatic severe MR due to flail leaflet, treated with MC. Seven days later, the echocardiography showed a large mass in the left atrium not visible previously, initially thought to be a thrombus. Further investigation using transoesophageal echocardiography showed a large formation, with uneven echogenicity, at the level of the left atrium without signs of obstructing mitral valve inflow. 3D-rendering was also performed, revealing an echolucent area between the endocardium and the left atrial free wall, presenting increase echogenicity portions, suggestive of being LAD with partial thrombosis inside. The patient was treated with unfractionated heparin and after six days the echocardiogram showed complete resolution of thrombotic elements, with residual double-track linear hyperechoic formation within the atrial posterior wall, identifying an anechoic space. Therefore, the echocardiographic features suggested the diagnosis of left atrial intramural hematoma, initially thrombosed, then dissolved. Conclusions LAD is a rare complication either of cardiosurgical and transcatheter procedures. Both operator awareness and imaging features are important for diagnosis. 3D rendering can be useful in the early differential diagnosis, facilitating an optimal management.

A case of iatrogenic left atrial intramural hematoma treated with combined therapy of surgical and transcatheter approaches

A case of iatrogenic left atrial intramural hematoma treated with combined therapy of surgical and transcatheter approaches

Left Atrial Intramural Hematoma Leading to Low Cardiac Output after Heart Transplantation

<h3>Introduction</h3> Low cardiac output state in the immediate post heart transplant (HTx) period requires rapid evaluation for aetiology. We describe an unusual mechanism for low cardiac output in a patient with reasonable bi-ventricular function in the perioperative period. <h3>Case Report</h3> A 45 year male underwent urgent HTx (for left ventricular non-compaction with recurrent VT). He had a prolonged bypass time with a 2^nd run for patch repair of the anterior wall of the pulmonary artery anastomosis. In the first six hours, thereafter he developed worsening hemodynamics (CI falling to 1.3, CVP 12-14, MAP 55-60, mPA 19) requiring escalating inotropic support and IABP along with CVVH for lactic acidemia. Transoesophageal echocardiography (TOE) showed a collection posterior to the LA with reasonable biventricular function (Figure 1). There was no gradient across the PA patch; confirmed by PA catheter and TOE. There was significant improvement in hemodynamics (CI 2.1, CVP 15, MAP 80s) on re-opening of the chest, but no collection was found. A diagnosis of intramural hematoma of the posterior wall of the LA was concluded. Subsequently, upon closure of chest an acute deterioration in hemodynamics re-developed. The chest was therefore left open, with improvement. The patient weaned to a single inotrope, with removal of IABP on post op day 2. A TOE on day 3 showed resolution of the intramural hematoma, and the chest was closed without further compromise. <h3>Summary</h3> Intramural hematoma of the LA can cause mass effect with resultant low cardiac output state. Recognition of this rare complication is important in the setting of low cardiac output and good ventricular function following HTx. Management is conservative, after re-exploration, and delayed sternal closure can be used until the hematoma has resolved.

A rare complication related to pulmonary vein isolation: intramural atrial hematoma.

A rare complication related to pulmonary vein isolation: intramural atrial hematoma.

LEFT ATRIAL INTRAMURAL HEMATOMA AFTER PERCUTANEOUS CORONARY INTERVENTION

Left intramural atrial hematoma (LAIH) is a rare complication that is characterized by the creation of a false chamber distinct from the true left atrium. It is reported to occur spontaneously or associated with percutaneous coronary intervention, aortic dissection, cardiac surgery, mitral and

CASE OF LEFT ATRIUM INTRAMURAL HEMATOMA AFTER PERCUTANEOUS CORONARY INTERVENTION

Left atrial Intramural hematoma (LAIH) is rare complication cardiac invasive procedures. The article analyses the mechanism of formation of this pathology. The case of the LAIH after percutaneous coronary intervention (PCI) is presented. The patient complained of intensive chest pain. When performing ECHO, LAIH was found. LAIH occupied a large part of the cavity left atrium. The conservative supervision of the patient was chosen despite the compession of the left inferior pulmonary vein and symptoms of the acute heart failure. The successful symptomatic treatment was conducted. Taking into consideration the recent PCI dual antiplatelet therapy was not interrupted. LAIH gradually regressed. Five weeks after the desease began, the patient was discharged from the hospital. Nine months after almost full lysis of LAIH was observed. The discussion section is devoted to the issues of diagnosis, the choice of medical tactics, the necessity of surgical treatment and the stop of antitrombotic theatment.

Spontaneous left atrial intramural hematoma with cystic degeneration

Spontaneous left atrial intramural hematoma with cystic degeneration

POST PCI COMPLICATION: LEFT ATRIAL INTRAMURAL HEMATOMA

Left atrial intramural hematoma(LAIH) due to a complication from percutaneous coronary intervention(PCI) causing outflow obstruction leading to overt heart failure is a rare complication. Patient was a 71-year-old male presented with acute exacerbation of heart failure and non-exertional chest pain

Conservative Management and 1-Year Follow-Up of a Huge Left Atrial Intramural Hematoma Related to an Epicardial Collateral Perforation During a Chronic Total Occlusion Percutaneous Coronary Intervention

A 68 year-old man, with multiple cardiovascular risk factors, prior stroke, moderate aortic stenosis, prior coronary artery bypass grafts and percutaneous coronary intervention (PCI) on the mid-circumflex coronary artery, was admitted to our hospital because of severe angina (Canadian Cardiovascular

A Case of Cardiac Leiomyosarcoma Diagnosed with Recurrence after Resection of the Left Atrial Intramural Hematoma

A Case of Cardiac Leiomyosarcoma Diagnosed with Recurrence after Resection of the Left Atrial Intramural Hematoma

Intramural atrial hematoma complicating transesophageal echocardiography during cardiac arrest

BackgroundAdequate strategies using either transthoracic (TTE) or transesophageal (TEE) echocardiography in patients receiving cardiopulmonary resuscitation (CPR) is an ongoing area of research. ObjectivesAs transthoracic point-of-care ultrasound (POCUS) during cardiac arrest resuscitation might result in an increased duration of interruptions in the delivery of chest compressions; the use of TEE has been proposed as an alternative. MethodsNo technical complications of either TTE nor TEE are so far being reported in the literature. ResultsWe report the case of a left intramural atrial hematoma complicating TEE procedure during cardiac arrest. This highlights a unique and to our knowledge, first-in-man, described complicating TEE procedure during CPR. ConclusionsFurther research on the safety of transesophageal echo during CRP is mandatory and the question about any potential harm of particular interest.

Left Atrial Intramural Hematoma after Surgical Aortic Valve Replacement

Left Atrial Intramural Hematoma after Surgical Aortic Valve Replacement

Spontaneous left atrial intramural hematoma associated with large hemorrhagic pericardial effusion

Atrial intramural hematoma is a rare entity. It was reported to occur spontaneously especially in patients with recent history of cardiac surgery or cardiac trauma. In this report, a case of spontaneous intramural hematoma associated with large bloody stained pericardial effusion presented with progressive shortness of breath as the primary clinical manifestation is described. The diagnosis was tentatively achieved by transesophageal echocardiography and cardiac computed tomography scan and was later confirmed during surgery. The patient recovered uneventfully following surgery and follow-up echocardiography demonstrated complete resolution of pre-existing hematoma.<Learning objective: We present a case of spontaneous intramural atrial hematoma and cardiac tamponade in a 61-year-old patient with a history of progressive shortness of breath. The proper diagnosis and surgical intervention are described. This case description will help increase the awareness regarding the diagnosis of this rare cardiac condition.>

Conservative Management of Left Atrial Intramural Hematoma after Catheter Ablation.

Left atrial intramural hematoma is a very rare complication of radiofrequency ablation procedures. A patient with tachyarrhythmia underwent radiofrequency catheter ablation. Echocardiography performed the following morning showed a large mass in the left atrium, suggestive of intramural hematoma formation. The patient was in a stable condition; therefore, it was decided that follow-up should be conservative and her anticoagulation therapy was continued. The size of the hematoma decreased significantly over the following 50 days. This case highlights a rare complication of a complex catheter ablation procedure in the left atrium that was managed via a noninvasive approach, with which all interventionists should be familiar.

Left Atrial Intramural Hematoma after Catheter Ablation for Atrial Tachyarrhythmia

We report the rare case of a 70-year-old man with a large intramural hematoma associated with radiofrequency catheter ablation for left side atrial tachyarrhythmias. The size of the hematoma increased, and it compromised mitral inflow within a day. Emergent open cardiac surgery was performed for hematoma evacuation and Cox-Maze procedure. He had no immediate postoperative complications and was free of tachyarrhythmia over a 1-year follow-up.

Intramural Atrial Hematoma: A Rare Complication of a Common Procedure

Intramural Atrial Hematoma: A Rare Complication of a Common Procedure

Left Atrial Wall Hematoma as a Consequence of Percutaneous Coronary Angioplasty

Intramural left atrial dissection and hematoma as a complication of a coronary stenting procedure is a very rare entity. We report the case of a 73-year-old man who underwent percutaneous coronary angioplasty for a severe stenosis of the left circumflex coronary artery, complicated by a left atrial intramural hematoma, and was successfully treated with via a minimally invasive port-access surgical approach.

Radiofrequency Ablation Complicated by Left Atrial Intramural Hematoma

Journal of Cardiovascular ElectrophysiologyVolume 23, Issue 6 p. 662-663 EP Image Radiofrequency Ablation Complicated by Left Atrial Intramural Hematoma MICHAEL F. MORRIS M.D., MICHAEL F. MORRIS M.D. Department of RadiologySearch for more papers by this authorJONATHON C. ADAMS M.D., JONATHON C. ADAMS M.D. Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Phoenix, Arizona, USASearch for more papers by this authorPRASAD M. PANSE M.D., PRASAD M. PANSE M.D. Department of RadiologySearch for more papers by this authorKOMANDOOR SRIVATHSAN M.D., KOMANDOOR SRIVATHSAN M.D. Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Phoenix, Arizona, USASearch for more papers by this author MICHAEL F. MORRIS M.D., MICHAEL F. MORRIS M.D. Department of RadiologySearch for more papers by this authorJONATHON C. ADAMS M.D., JONATHON C. ADAMS M.D. Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Phoenix, Arizona, USASearch for more papers by this authorPRASAD M. PANSE M.D., PRASAD M. PANSE M.D. Department of RadiologySearch for more papers by this authorKOMANDOOR SRIVATHSAN M.D., KOMANDOOR SRIVATHSAN M.D. Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Phoenix, Arizona, USASearch for more papers by this author First published: 17 August 2011 https://doi.org/10.1111/j.1540-8167.2011.02150.xCitations: 7 Komandoor Srivathsan, M.D., Division of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. Fax: 480-342-1606; E-mail: srivathsan.komandoor@mayo.edu J Cardiovasc Electrophysiol, Vol. 23, pp. 662–663, June 2012 No disclosures. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume23, Issue6June 2012Pages 662-663 RelatedInformation