Key result
Conservative management with anticoagulation led to an almost complete resolution of a postoperative left atrial intramural hematoma at 3 months follow-up.
Case Report (n=1)
No
Conservative management with anticoagulation and serial imaging can be an appropriate and successful strategy for a hemodynamically stable patient with a postoperative left atrial intramural hematoma.
Supports feasibility of conservative management for postoperative left atrial intramural hematoma; hypothesis-generating and leaves open need for prospective data.
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.
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Bruegger et al. (2011) conducted a case report in Left atrial intramural hematoma (n=1). Conservative management (anticoagulation) was evaluated on Resolution of hematoma. Conservative management with anticoagulation led to an almost complete resolution of a postoperative left atrial intramural hematoma at 3 months follow-up.
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