Left Atrial Ball-Shaped Thrombus with Concomitant Biatrial Appendage Thrombi in a Patient with Prior Mitral Valve Replacement

Abstract

We reported a 67-year-old woman in whom large atrial thrombi were found by chance during discontinuation of therapeutic anticoagulation. The patient, with a history of mitral valve replacement surgery, had stopped anticoagulation for months because of intractable gastrointestinal bleeding, during which she was found to have 3 large thrombi in the atria on transesophageal echocardiography: left atrial free-floating ball-shaped thrombus, left atrial appendage thrombus, and right atrial appendage thrombus. One month following diagnosis, she still had the free-floating thrombus despite adequate anticoagulation. Free-floating ball-shaped thrombus is a rare finding observed on echocardiography in patients with mitral valve disease and an even rarer finding in case of appendage thrombi coexisting.

Resolution of Left Atrial Thrombus in Severe Mitral Stenosis Patients After Three Months of Anticoagulation

“…14 PTMC after complete clearance of LAA thrombus with oral anticoagulation minimizes the chances of thromboembolic events. 15,16 Although thrombus clearance has been reported with long-term oral anticoagulation, [17][18][19][20][21][22][23] the clinically significant consequence of short-term anticoagulation has not being documented earlier and is not well established. http://www.…”