Infective left atrial dissecting flap after cardiac surgery

Area of Science:

• Cardiology
• Cardiac Surgery
• Infectious Diseases

Background:

• Left atrial dissection (LatD) is a rare but severe complication following cardiac surgery.
• It is often associated with injuries to the atrioventricular junction.

Observation:

• A patient developed septicemia and disseminated intravascular coagulation post-coronary artery bypass graft, mitral valve replacement, aortic valve replacement, and ascending aortic root replacement.
• The patient presented with symptoms indicative of a severe systemic infection.

Findings:

• Infected left atrial dissection (LatD) was diagnosed.
• Transesophageal echocardiography identified a dissecting flap in the left atrium with attached infective vegetations.
• This represents the first reported case of concomitant infected LatD and vegetations visualized by echocardiography.

Implications:

• This case underscores the importance of considering infected LatD in patients with severe sepsis after complex cardiac surgery.
• Early and accurate diagnosis using transesophageal echocardiography is crucial for timely intervention.
• Further research may elucidate optimal management strategies for this rare condition.