[Echocardiographic diagnosis of a free and obstructive thrombus of the left atrium: a surgical emergency. Review of the literature apropos of a case].
Thrombosis of the left atrium is frequent and often causes systemic embolism in patients with mitral valve regurgitation and major atrial dilatation. In contrast, free floating thrombi unconnected to the atrial wall are extremely rare and characterized by their great mobility and the risk they create of haemodynamic disturbances due to mitral valve obstruction. We report here one case of such a thrombus and compare our findings with those reported in the literature concerning 7 other cases diagnosed by echocardiography. The echocardiographic diagnosis of free floating thrombus is easier than that of adherent thrombus. The free floating thrombus may result from the release of an initially pedunculate thrombus, or it may form in the atrial cavity independent of the atrial wall. Its origin can only be determined at pathological examination. Emergency surgery is mandatory when faced with this situation at high risk of haemodynamic disturbances and embolism.
D000368:Aged; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D013927:Thrombosis / Q000175:diagnosis*
Diagnostic échocardiographique d'un thrombus libre et obstructif de l'oreillette gauche: une urgence chirurgicale. Revue de la littérature à propos d'un cas.