ABSTRACT
A 66-year-old male patient with mitral regurgitation and atrial fibrillation underwent mitral valvuloplasty with a modified maze procedure. Follow-up echocardiography performed on the 4th postoperative day revealed a high echoic mass of 6.7 x 3.0 cm which appeared continuous to the left atrial wall and protruded into the left atrial cavity. The irregular surface of the mass echo was not compatible with atrial wall hematoma, so computed tomography (CT) was performed for the differential diagnosis. CT showed extension of the mass from the left atrium to the interatrial septum and right atrium, which lead to a conclusive diagnosis of atrial wall hematoma. Echocardiography showed the hematoma was diminished and eventually disappeared after simply reducing the warfarinization level. This rare case of atrial wall hematoma, especially after the maze procedure, required differential diagnosis from intraatrial thrombus and atrial wall dissection.
