case_images: PMC11331426_01
case_images: After being weaned from CPB, a rapidly increasing left atrial dissection hematoma (indicated by the yellow arrow) was visible in the posterior atrioventricular groove of the left atrial posterior wall. It gradually compressed the mitral valve annulus, causing relative stenosis of the left ventricular inflow tract.
case_images: fcvm-11-1413713-g001.jpg
case_images: PMC11331426_01_fcvm-11-1413713-g001.jpg
case_images: F1
case_images: TEE and discovered a hematoma on the posterior wall of the left atrium, measuring approximately 3 x 4 cm in diameter (Figure 1). This hematoma was rapidly expanding and gradually compressing the mitral valve annulus.
case_images: TEE detected pulsatile blood flow in the hematoma located at the left atrioventricular groove on the posterior wall of the left atrium.
case_images: fcvm-11-1413713-g002.jpg
case_images: PMC11331426_01_fcvm-11-1413713-g002.jpg
case_images: F2
case_images: In addition, TEE found pulsatile blood flow in the hematoma at the left atrioventricular groove on the posterior wall of the left atrium after the second cardiopulmonary bypass (Figure 2), suggesting that this blood flow was related to the left coronary circumflex branch.
case_images: The yellow arrow indicates the site of incision and drainage. (A) Surgical treatment method: After confirming the integrity of the left atrial endocardium and the correct position of the artificial valve, the left atrial endocardium was incised for decompression and drainage. (B) TEE 3D reconstruction detected the drainage port of the left atrial endocardium incision for decompression.
case_images: fcvm-11-1413713-g003.jpg
case_images: PMC11331426_01_fcvm-11-1413713-g003.jpg
case_images: F3
case_images: Because the criminal's blood flow (blood vessels) was located in the posterior atrioventricular groove and could not be explored through a surgical incision, we ultimately decided to incise the left atrial endocardium to drain the decompression hematoma through the left atrium (Figures 3, 4).
case_images: The hematoma on the posterior wall of the left atrium significantly decreased in size after incision of the left atrial endocardium for decompression and drainage.
case_images: fcvm-11-1413713-g004.jpg
case_images: PMC11331426_01_fcvm-11-1413713-g004.jpg
case_images: F4
case_images: Because the criminal's blood flow (blood vessels) was located in the posterior atrioventricular groove and could not be explored through a surgical incision, we ultimately decided to incise the left atrial endocardium to drain the decompression hematoma through the left atrium (Figures 3, 4).