A novel clinical course of free-floating left atrial ball thrombus without mitral stenosis treated by anticoagulants

Tanoue, Kazuyuki; Sonoda, Masahiro; Maeda, Naonori; Ikeda, Daisuke; Tashiro, Hitoshi; Tanoue, K.; Terashi, Toshihiko; Nakamura, Kazuhiko

doi:10.1016/j.jjcc.2008.11.003

Cited by 12 publications

(10 citation statements)

References 8 publications

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“…Several clinical states prone to left atrial thrombi include mitral stenosis, atrial fibrillation, severe left atrial dilatation, status of post mitral valve replacement, congestive heart failure, bradycardia, exogenous material in the left atrium, dysfunction of coagulating system, low cardiac output, myocarditis, hypertrophic cardiomyopathy, and infectious endocarditis [13–16]. In the present case, the patient’s coagulating system was normal; however, she had a past history of severe MR after MVR and was under treatment for chronic AF.…”

Section: Discussionmentioning

confidence: 99%

A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

et al. 2017

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Patient: Female, 74Final Diagnosis: Left atrial ball thrombusSymptoms: Abdominal discomfort • dyspneaMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Rare diseaseBackground:A free-floating ball thrombus in the left atrium is a rare clinical condition. However, the diagnosis of this condition has been facilitated by the advent and development of echocardiography and multi-detector row computed tomography (MDCT) and several cases have been reported.Case Report:We report a case of a 75-year-old woman who had recurrent giant spherical thrombi in the left atrium. She was diagnosed with chronic atrial fibrillation at 52 years of age. A pacemaker implantation was performed at 54 years of age because of a complete atrioventricular block; and mitral valve replacement was performed for severe mitral regurgitation at 62 years of age. She had a history of cerebral infarction and she was under treatment for chronic heart failure.Despite intensive anticoagulant therapy, she developed ball thrombi in the left atrium three times in six months. During hospitalization for acute myocardial infarction treated with percutaneous catheter intervention, transthoracic echocardiography and computed tomography (CT) revealed a free-floating giant spherical thrombus in the left atrium. She was treated with intensive anticoagulation therapy and the left atrial ball thrombus disappeared; however, two ball thrombi in the left atrium and left atrial appendage recurred after three months. Surgical removal of the thrombi and closure of the left atrial appendage were performed. Unfortunately, a ball thrombus in the left atrium recurred again after a further three months.Conclusions:The present case highlights the difficulty of treating refractory thrombi in the left atrium.

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Section: Discussionmentioning

confidence: 99%

A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

et al. 2017

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“…There is a single case report of successful treatment of free floating left atrial ball valve thrombus with anticoagulants. 6 …”

Section: Discussionmentioning

confidence: 99%

Left atrial ball valve thrombus in restrictive cardiomyopathy and normal mitral valve: Loose cannon in heart

Karim

Sharma

Bahl

2015

Indian Heart Journal

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Left atrial ball valve thrombus is an unusual condition, especially in patients with normal mitral valve. In the present case, we describe a 61-year-old female with restrictive cardiomyopathy who presented with a large left atrial ball valve thrombus, which subsequently embolized to right carotid artery and was treated with intravenous thrombolysis. This case provides useful insight into the genesis of such thrombi and highlights management dilemmas of a rare clinical problem.

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“…Left atrial ball thrombus is a rare condition, first recognized in autopsy in the early XIX century. Left atrial free-floating thrombus is mostly associated with the disease of the mitral valve [12,13] but has also been acquainted in association with atrial fibrillation [14] and hypertrophic cardiomyopathy [15]. The etiology of ball thrombus formation in the lack of structural heart disease or AF is mostly unknown, but metastatic carcinoma is a diagnosis worth giving consideration to [16].…”

Section: Discussionmentioning

confidence: 99%

Occult left atrial ball-like thrombus in a patient referred for surgical removal of suspected cerebellum tumor.

et al. 2014

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SummaryBackgroundAtrial fibrillation and related cardio-embolic cerebrovascular accidents are two well-defined major healthcare problems worldwide. It has been approximated that 2.2 million people in America and 4.5 million in European Union have paroxysmal or persistent atrial fibrillation. And atrial fibrillation itself is an independent long-term risk factor of stroke. We present a case of patient referred to our center for surgical removal of suspected cerebellum tumor, a case that had a rather unexpected ending.Case ReportA 58-year-old male patient with a history of atrial fibrillation, congestive heart failure (NYHA II/III), stable coronary artery disease, diabetes type 2 and hyperlipidemia presented with vertigo, headaches, mainly during physical activity and increased tiredness. Performed computer tomography revealed two lesions in the cerebellum and in the left lateral chamber. The diagnosis of a proliferative disease of the cerebellum was established and patient was referred to the Neurosurgical Department. Fortunately, before the operation the echocardiography was performed, which revealed two lesions in left atrium. The decision of the Heart Team was to refer the patient for an open-heart surgery, in which two thrombi were removed. Neurosurgeons decided to withdraw from further surgery and proceed with head MRI and conservative treatment, deciding that the lesion in the cerebellum was most likely an ischemic area.ConclusionsLooking at the brain lesion should always be done from the whole patient’s perspective. And using mutlimodality imaging may lead to appropriate diagnosis, correct course of therapeutic action and unexpected ending of a rather non-extraordinary case.

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A novel clinical course of free-floating left atrial ball thrombus without mitral stenosis treated by anticoagulants

Cited by 12 publications

References 8 publications

A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

Left atrial ball valve thrombus in restrictive cardiomyopathy and normal mitral valve: Loose cannon in heart

Occult left atrial ball-like thrombus in a patient referred for surgical removal of suspected cerebellum tumor.

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