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Heart 2000;84:514-519; doi:10.1136/heart.84.5.514
Copyright © 2000 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2000;84:514-519 ( November )

Images in cardiology

Isolated left atrial tamponade following circumflex artery angioplasty

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An 80 year old man presented with unstable angina four weeks after undergoing two vessel coronary artery bypass surgery. Percutaneous transluminal coronary angioplasty of an ungraftable circumflex artery was complicated by a coronary artery perforation. The patient was initially stable but after several hours developed haemodynamic instability. Transthoracic and later intraoperative transoesophageal echocardiography revealed a large isolated haematoma in the oblique sinus compressing the posterior left atrium (A, short axis view through the aortic valve; AO, aortic valve; LA, left atrium; RA, right atrium; TH, thrombus). An emergency left posterior left thoracotomy was performed and the thrombus evacuated with relief of the left atrial compression (B). No further cardiac intervention was required and the patient was successfully discharged.

ALEXANDER KADNER, RAYMOND H CHEN, CHARLES D COLLARD, DAVID H ADAMS

© 2000 by Heart
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This article has been cited by other articles:

  • van Rooijen, J. M., van den Merkhof, L. F.M. (2008). Left atrial impression: a sign of extra-cardiac pathology. Eur J Echocardiogr 9: 661-664 [Abstract] [Full Text]  
  • Tavano, D., Carlino, M., Pisani, M., Colombo, A. (2007). Conservative Treatment of a Left Atrial Hematoma and a Localized Tamponade Occurring During Treatment of Coronary Total Occlusion. Circulation 115: e603-e606 [Full Text]  

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