{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:35:20Z","timestamp":1788420920970,"version":"build-2803163510"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left atrial dissection (LAtD) is a rare but potentially life-threatening complication of mitral valve surgery. Its management is not well stablished in the literature. However, early recognition through intraoperative TEE and attention to changes in the left atrial free wall during saline leak testing can lead to avoidance of severe complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a case of LAtD detected by intraoperative transesophageal echocardiogram (TEE) following mitral valve repair for primary mitral valve regurgitation secondary to degenerative mitral valve disease with MAZE IV procedure for atrial fibrillation. LAtD was noted on TEE as an expanding double density along the wall of the left atrium with a jet originating at the posterior annulus flowing into the LAtD which was repaired. Separation from bypass following LAtD repair was complicated by severe biventricular dysfunction requiring significant inotropic support and placement of an intra-aortic balloon pump (IABP). Patient\u2019s post-operative course was further complicated by right sided heart failure requiring placement of a right sided impella which was subsequently removed on POD 4. Patient was discharged home on POD 17. Transthoracic echo at 1 month, 3 months demonstrated resolution of the LAtD. A follow up echo at 4 years showed complete resolution of the LAtD with an intact mitral repair, trace mitral regurgitation, and a mean gradient across the repair of 3\u00a0mm Hg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Left atrial dissection is a rare but serious complication of mitral valve surgery. We provide a review of the current literature regarding LAtD, emphasizing the need to consider this complication early during mitral surgery to allow for uncomplicated repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-024-02641-x","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T03:02:43Z","timestamp":1710817363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Recognition and management of left atrial dissection during mitral repair"],"prefix":"10.1186","volume":"19","author":[{"given":"Haya","family":"Alshaabi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack F.","family":"Donaghue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Franko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jock N.","family":"McCullough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"2641_CR1","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1007\/s11748-015-0562-7","volume":"63","author":"H Tsukui","year":"2015","unstructured":"Tsukui H, Iwasa S, Yamazaki K. Left atrial dissection. Gen Thorac Cardiovasc Surg. 2015;63:434\u201345.","journal-title":"Gen Thorac Cardiovasc Surg"},{"issue":"1","key":"2641_CR2","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1093\/icvts\/ivu317","volume":"20","author":"S Fukuhara","year":"2015","unstructured":"Fukuhara S, Dimitrova KR, Geller CM, Hoffman DM, Tranbaugh RF. Left atrial dissection: an almost unknown entity. Interact Cardiovasc Thorac Surg. 2015;20(1):96\u2013100.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"5","key":"2641_CR3","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1016\/j.athoracsur.2012.12.041","volume":"95","author":"S Fukuhara","year":"2013","unstructured":"Fukuhara S, Dimitrova KR, Geller CM, Hoffman DM, Ko W, Tranbaugh RF. Left atrial dissection: etiology and treatment. 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Anesth Analgesia. 2009;109(5):1409\u201312.","journal-title":"Anesth Analgesia"},{"issue":"2","key":"2641_CR8","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1053\/euje.2000.0020","volume":"1","author":"M Martinez-Sell\u00e9s","year":"2000","unstructured":"Martinez-Sell\u00e9s M, Garc\u0131\u0301a-Fernandez MA, Moreno M, Bermejo J, Delc\u00e1n JL. Echocardiographic features of left atrial dissection. Eur J Echocardiography. 2000;1(2):147\u201350.","journal-title":"Eur J Echocardiography"},{"issue":"1","key":"2641_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40792-021-01194-8","volume":"7","author":"K Kiryu","year":"2021","unstructured":"Kiryu K, Kadohama T, Itagaki Y, Yamaura G, Tanaka F, Takagi D, Wada T, Igarashi I, Yamazaki Y, Yamamoto H. Avoiding anticoagulation drugs for postoperative atrial fibrillation enabled successful conservative treatment of left atrial dissection: a case report. 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