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

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  • 医原性の左房壁内血腫に対し外科的治療とカテーテル治療を施行した症例
  • イ ゲンセイ ノ サボウヘキ ナイ ケッシュ ニ タイシ ゲカテキ チリョウ ト カテーテル チリョウ オ シコウ シタ ショウレイ

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Abstract

<p>　Left atrial intramural hematoma is a very rare condition that creates a gap in the left atrial wall or atrial septum and forms a false cavity.</p><p>　We encountered a case of acute heart failure due to left atrial intramural hematoma, which was managed with anesthesia. The case involved a 79-year-old man. The coronary artery was injured by percutaneous coronary angioplasty; the following day, transthoracic echocardiography was performed, revealing a hematoma in the left atrial wall. We removed the hematoma under cardiopulmonary bypass and subsequently embolized the injured coronary artery. The large left atrial intramural hematoma impaired blood inflow in the mitral valve and caused hemodynamic instability; thus, we avoided a sudden decrease in preload or tachycardia, and we managed the case safely. Multimodal therapy with a surgical and transcatheter approach is useful for iatrogenic left atrial hematoma.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 26 (1), 33-37, 2022-09-01

    Japanese Society of Cardiovascular Anesthesiologists

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