Right atrial mural thrombi

Abstract

Background:Right atrial mural thrombi (RAMT) are often seen in association with cardiac diseases or foreign bodies. Unusual locations at the flutter isthmus and the atrial appendage prompted us to evaluate our 2-year autopsy data on such thrombi.Materials and Methods:In the 2-year retrospective autopsy, the clinical and autopsy records of patients with RAMT were reviewed, with particular reference to the presence of central venous catheter (CVC), its site of insertion, its type, material and size, its duration of placement, and the drugs infused through the catheter.Results:Of the 940 autopsies performed in 2 years, RAMT was seen in 24 hearts and was related to an insertion of a CVC in 23 patients (95.8%). The risk and/or associated factors for this complication were tunneled and polyethylene catheters, Intensive Care Unit admission, infused drugs, underlying cardiac diseases, and pregnancy. A noteworthy feature was the location of the thrombi in the flutter isthmus in 16 hearts (66.7%) and atrial appendage in another six hearts. Localized endocarditis/myocarditis and pulmonary thromboembolism were observed in six and four patients, respectively.Conclusions:This autopsy study, which has a high incidence of catheter-related RAMT, does not reflect the true incidence but reiterates the importance of guided insertion of central venous and prompt recognition of thrombus formation.

Calcified Right Atrial Thrombus With Near-Systemic Pulmonary Pressures in a Morbidly Obese Patient: A Clinical Conundrum

“…In contrast, type B thrombi are often stationary, fixed to the right atrial wall, and less susceptible to thrombolysis [8,10]. They are uncommon in a structurally normal heart but can however occur in hypercoagulable states, right atrial catheterization, pacemaker implantation, low cardiac output states, septal closure devices, cardiac trauma, cardiomyopathies, indwelling central venous lines, cardiac arrhythmias, neoplastic processes, and some systemic diseases [8,11,12]. They are generally associated with a favourable prognosis given that they are often adherent to the right atrial wall and are less likely to embolize, thus making them a low-risk group compared to type A [3,13].…”

Aortic thrombus with contraceptive vaginal ring use

“…A case series of 30 non-atherosclerotic and non-aneurysmal aortic thrombosis events identified that 47% of the cases involved the abdominal aorta. 14 The majority of cases occurred between the third and fourth decade of life. Primary causes were attributed to hypercoagulable states and aortic wall changes.…”

Incidental Finding of a Large Right Atrial Thrombus in a Patient With Cerebral Lymphoma

“…Twenty-three of these patients had CVC insertion before death. 1 The back-and-forth motion of the catheter within the RA cavity is believed to produce mechanical trauma in the RA, predisposing to mural thrombus formation. The prior history of prolonged CVC placement for chemotherapy in our case may have predisposed for thrombus formation; however, catheter placement and thrombosis were remote (18 years prior).…”