[Left atrial thrombus. Its evolution with oral anticoagulation].
Left ventricular thrombi were found in 25 patients by two-dimensional echocardiography. All patients were in atrial fibrillation, 16 had mitral or mitroaortic valve diseases and nine mitral or mitroaortic bioprosthetic valves. Nine patients (36%) had history of arterial embolism. At diagnostic time, oral anticoagulation with coumadin was instaured in all the patients. Periodic clinic and echocardiography follow-up was performed. Left atrial thrombi either disappeared (18 patients [72%]) or reduced their size (one patient). Six patients with mitral stenosis were considered as candidates to percutaneous mitral valvuloplasty, which was performed in 4 patients whose thrombi disappeared with anticoagulation therapy in 6 months. During the follow-up one patient had cerebral embolism without sequelae.


CONCLUSIONS
1st. Patients with left atrial thrombi have high risk for arterial embolism. 2nd. Left atrial thrombi disappear in a high proportion after prescribing oral anticoagulation, which has some important therapeutic implications.
Sobrino
J A
JA
Unidad Médico Quirúrgica de Cardiología, Hospital La Paz, Facultad de Medicina, Universidad Autónoma, Madrid.
Centeno
J E
JE
Maté
I
I
Mesa
J M
JM
Oliver
J M
JM
Silvestre
J
J
Domínguez
F
F
Sobrino
N
N
Rico
J M
JM
Rubiano
R
R
D000284:Administration, Oral; D001021:Aortic Valve; D001705:Bioprosthesis; D003374:Coumarins / Q000008:administration & dosage*; D004341:Drug Evaluation; D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006349:Heart Valve Diseases / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology
D003374:Coumarins
Trombo auricular izquierdo. Evolución con anticoagulación oral.