Giant Thrombus Formation Immediately After Mitral Valvuloplasty

Aizawa, Yoshihiro; Nakai, Toshiko; Kurosawa, Tsumugi Anne; Saito, Yuki; Monno, Koyuru; Hatta, Takumi; Hiro, Takafumi; Arimoto, Munehito; Osaka, Shunji; Hata, Hiroyuki; Shiono, Motomi; Hirayama, Atsushi

doi:10.1536/ihj.15-192

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Aizawa, et al reported a case of giant atrial thrombus formation immediately after mitral valvuloplasty and LAA resection performed as an open heart procedure. 5) Due to this concern, we routinely perform cardiac contrastenhanced CT on the 2nd postoperative day. From our experience, we found that thrombus along the stapling line was formed approximately 27% of cases (19 out of 70 cases) after thoracoscopic left atrial appendectomy.…”

Section: Discussionmentioning

confidence: 99%

A Case of Cardiogenic Stroke After Thoracoscopic Left Atrial Appendectomy

et al. 2018

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Thoracoscopic left atrial appendectomy is a minimally invasive procedure for left atrial appendage occlusion in patients with non-valvular atrial fibrillation, particularly those at a great risk for both stroke and bleeding despite appropriate oral anticoagulant therapy. It serves as an alternative strategy for stroke risk reduction. Moreover, the oral anticoagulant therapy can be discontinued after the operation. However, we encountered a 74-year old male patient who developed cardiogenic stroke after thoracoscopic left atrial appendectomy. We report this case to introduce how we evaluate the risk of postoperative cardiogenic stroke by means of contrast-enhanced cardiac computed tomography (CT), and how we formulate the postoperative patient management strategy including short-term oral anticoagulation therapy by using results of cardiac CT.

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Section: Discussionmentioning

confidence: 99%

A Case of Cardiogenic Stroke After Thoracoscopic Left Atrial Appendectomy

et al. 2018

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“…8) Thus, 3D TTE is a diagnostic imaging method complementary to 2D TTE. 9) Combining 2D and 3D TTE is extremely beneficial in the complete cardiac assessment and management of DOMV. Additionally, surgery is required when there are other complex cardiac malformations present, complicated with severe stenosis, insufficiency, or both.…”

Section: Three-dimensional Echocardiography Of Domvmentioning

confidence: 99%

Congenital Double-Orifice Mitral Valve in Asymptomatic Patients

Liu

Ren

et al. 2018

Int. Heart J.

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SummaryCongenital double-orifice mitral valve (DOMV) is a rare malformation that may affect both mitral valve and apparatus, and it is usually associated with other cardiac disorders. Asymptomatic DOMV is extremely rare. We present two similar cases of asymptomatic congenital double-orifice mitral valve. Both cases presented functionally normal mitral valve apparatus with two equally sized orifices, which were formed by a central fibrosis. In addition, final confirmatory diagnosis was made using three-dimensional (3D) echocardiography in both cases.( DOMV was thought to be rare since it only accounts for 1% of congenital heart diseases.2) It is generally associated with other congenital abnormalities, including aortic coarctation, atrial septal defect, patent ductus arteriosus, or complex congenital heart disease. About half of patients had reasonable function, whereas others presented with significant mitral stenosis or regurgitation. Most cases can be diagnosed by transthoracic two-dimensional echocardiography (2D TTE). However, it is difficult to recognize it in asymptomatic patients. Transthoracic three-dimensional echocardiography (3D TTE) provides a reliable and comprehensive assessment of mitral valve and associated malformations.3) We describe two asymptomatic cases of DOMV fully assessed by 3D TTE. Case ReportsCase 1: A 57-year-old man was referred to our hospital for cardiac assessment. His blood pressure was 120/80 mmHg and heart rate 76 bpm on physical examination. The heart sound was normal with auscultation. Electrocardiography (ECG) and chest X-ray were inconclusive. The parasternal long axis view showed a restricted movement of the mitral valve ( Figure 1A); however, the parasternal short axis view revealed double-orifice mitral valve with equal size in mitral position ( Figure 1B). There was trivial mitral regurgitation in mitral position. Color Doppler imaging showed that the blood flow in the mitral valve was divided into two parts ( Figure 1C), and pulsed wave Doppler confirmed no mitral stenosis in this regard (Figure 1D). 3D TTE showed that the mitral valve was divided into two adequate orifices by a central bridge of fibrous tissue, and the papillary muscles were normal with chordate inserting into two papillary muscles (Figure 2). The patient was scheduled for follow-up. Case 2: A 20-year-old man presented for further cardiac examination. He was in good physical condition with blood pressure 120/80 mmHg and heart rate 93 bpm. His ECG and chest X-ray were without remarks. 2D TTE showed normal cardiac dimension and function. The aortic valve was bicuspid without stenosis or regurgitation. The parasternal long axis view demonstrated restricted movement of the mitral valve, but adequate opening was visualized when slightly rotating the transducer. The parasternal short axis view revealed double-orifice mitral valve of approximately equal size in mitral position. The mitral flow was normal without regurgitation. 3D TTE confirmed central fibrous bridge in the middle of mitral valve without othe...

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