# Left Atrial Dissection After Mitral and Aortic Valve Replacement: The Importance of Early Diagnosis of a Rare Entity

## TL;DR

A rare case of left atrial dissection after heart valve surgery is reported, emphasizing the importance of early diagnosis and conservative treatment.

## Contribution

The paper presents a rare clinical case and highlights the role of echocardiography in managing left atrial dissection.

## Key findings

- Left atrial dissection occurred in a patient after combined aortic and mitral valve replacement.
- Conservative management with echocardiography led to full recovery without surgical intervention.

## Abstract

Background and Clinical Significance: Left atrial dissection is a rare surgical complication (occurring in 0.16% of cases), which results in the formation of a large cavity between the endocardium and the epicardium. Case Presentation: We report a case of a 78-year-old man who underwent combined aortic and mitral valve replacement. Extensive debridement of the calcified mitral annulus most probably precipitated the formation of a dissection flap detected by transesophageal echocardiography after protamine administration. Profound hypotension and hemodynamic instability were treated with inotropic and vasopressor support and fluid administration without any further surgical intervention. Conclusions: The patient recovered uneventfully under conservative management, highlighting the importance of perioperative echocardiography for prompt diagnosis and tailored intervention.