Why the study?
What is the prevalence and diagnostic approach for left atrial dissection in patients with mitral valve prosthesis?
What is the prevalence and diagnostic approach for left atrial dissection in patients with mitral valve prosthesis?
Transoesophageal echocardiography is the preferred modality for diagnosing left atrial dissection, a rare but severe complication occurring in approximately 0.84% of patients with mitral valve prostheses.
AIMS: To study left atrial dissection, a rare complication of mitral valve replacement. METHODS AND RESULTS: From our hospital database of 5497 transoesophageal echocardiograms, we analysed 524 echocardiograms performed on 478 patients with mitral valve prosthesis. We found four patients (0.84%) with left atrial dissection diagnosed by transoesophageal echocardiography that visualized the left atrial dissection: in three patients the diagnosis was confirmed intraoperatively. Three patients had previously had replacements of the mitral valve. Left atrial dissection was a severe complication: one patient died and the two patients successfully operated on had paraprosthetic regurgitation. CONCLUSION: Transoesophageal echocardiography is the first choice for diagnosis of left atrial dissection, a rare complication of mitral valve replacement with an acute/subacute clinical course. Previous mitral valve replacement seems to be the main risk factor to develop left atrial dissection.
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Manuel Martínez‐Sellés (2000) studied this question.
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