An unusual echocardiographic presentation of left atrial dissection following cardiopulmonary cerebral resuscitation

Chia-Ling Lee^{a, b}, Yi-Tso Cheng^c, Ming-Chon Hsiung^d, Chen-Fuh Lam^b

^a Institution of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
^b Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^c Department of Thoracic and Cardiovascular Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^d Division of Cardiology, Cheng Hsin General Hospital, Taipei, Taiwan

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract

Left atrial dissection (LatD) is a relatively rare perioperative complication during mitral valve repair. Here, we report a 64-year-old man who developed LatD after cardiopulmonary resuscitation was needed due to an extensive myocardial infarction. Aggressive cardiac massage resulted in cardiac rupture and massive bloody pleura effusion. Intraoperative three-dimensional transesophageal echocardiography revealed posterior-medial papillary muscle ruptured and separation of the endocardium from the left atrial myocardium. We speculate that this is the first report in the literature of LatD after cardiopulmonary cerebral resuscitation.

Keywords

Cardiac rupture; Echocardiography; Left atrial dissection; Resuscitation