Left atrial dissection after a supra-annular mitral valve replacement for endocarditis

Background: left atrial dissection is a rare and a potentially fatal complication of cardiac surgery. Multi-modal imagery is helpful for the diagnosis and to guide the treatment. Case presentation : we report the case of a 66-year-old patient who underwent a combined mitral and aortic valve replacement. She underwent a replacement of the aortic and mitral prosthetic valves and the implantation of a leadless pacemaker 4 weeks later because of a paroxystic third-degree atrioventricular block complicating an infectious endocarditis. After the second surgery, she developed a severe pulmonary oedema. The transoesophageal echocardiography revealed a left atrial wall dissection and the apparition of a false aneurysm. A synchronized cardiac CT-scan confirmed a false aneurysm behind the left atrium. Conclusions: : multi-modal imagery including transoesophageal echocardiography and cardiac CT-scan is helpful for the diagnosis of left atrial dissection and to guide the treatment.