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Korean Journal of Anesthesiology 2004;46(4):489-492.
DOI: https://doi.org/10.4097/kjae.2004.46.4.489   
Left Atrial Dissection by Aorto-Left Atrial Fistula after Aortic Valve Replacement: A case report.
Il Woo Shin, Seong Ho Ok, Ju Tae Sohn, Heon Keun Lee, Young Kyun Chung
Department of Anesthesiology and Pain Medicine, Gyeongsang National University Medical School, Jinju, Korea.
Left atrial dissection is an uncommon entity, and is generally associated with mitral valve surgery, blunt chest trauma, intramyocardial dissecting hematoma after AMI, Behcet's disease, and infective endocarditis. Moreover, debridement of very calcified valves or inadvertent incision of the annulus may occur during the surgical procedure, and hemodynamic influence of a paraprosthetic leak may extend the dissection into the left atrial wall. We report a case with a mobile intimal flap of the left atrial wall detected by intraoperative transesophageal echocardiography after aortic valve replacement. An intraoperative transesophageal echocardiographic examination is needed for aortic valve replacement, especially when aortic stenosis is combined with severe annulus calcification.
Key Words: aortic stenosis; aortic valve replacement; left atrial dissection; transesophageal echocardiography


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