Right atrial wall hematoma following percutaneous mitral valvuloplasty

SummaryA 50-year-old male underwent successful percutaneous mitral valvuloplasty for restenosis after surgical commissurotomy. Trans-septal puncture was difficult. Following the procedure, the patient developed chest pain and signs of systemic venous congestion, yet no hemodynamic collapse. Echocardiographic evaluation revealed a cystic mass compressing the right atrium, not communicating with the atrial cavity, mostly an intramural hematoma. The case was managed conservatively, and serial echocardiographic follow-up showed gradual reduction in size until ultimate disappearance of the mass 1 month later. In conclusion, right atrial intramural hematoma is a possible complication of mitral valvuloplasty, readily detected by echocardiography, and amenable for conservative management.