Treatment of left atrial dissection after mitral repair: Internal drainage

Two patients with intraoperative dissection of the entire left atrium after mitral valve repair are presented. Intraoperative transesophageal echocard iography detected left atrial dissection with formation of a large cavity c ompressing the left atrium. The false lumen was opened and widely connected Co the right atrium to perform the decompression. This technique permits t he runoff into the low pressure system in case of persisting hemorrhage fro m the unknown entry, and eliminates the risk of systemic embolization from the cavity. (C) 1999 by The Society of Thoracic Surgeons.