Two cases of a free-floating ball thrombus in the left atrium.
A free-floating ball thrombus in the left atrium is an unusual occurrence that may cause fatal systemic emboli or left ventricular inflow obstruction, often resulting in sudden death. The first of 2 cases was a 59-year-old female with mitral stenosis and chronic atrial fibrillation who presented with severe dyspnea. Transthoracic echocardiography revealed a free-floating ball thrombus and emergency thrombectomy and mitral valve replacement were performed successfully. A second thrombus, which was not found at preoperative examination, was attached to the anterior mitral leaflet and may have been the source of the free-floating ball thrombus. The second case was a 79-year-old female with chronic renal failure who underwent mitral valve replacement 11 years prior to admission. She had been dependent on hemodialysis for 10 years, and had suffered several recent transient cerebral ischemic attacks. Computed tomography showed a ring-shaped, high-density area in the left atrium and transthoracic echocardiography revealed a floating ball thrombus in the left atrium. Thrombectomy was performed, but the patient died as a result of postoperative pneumonia 2 months later. Case 2 appears to be the first reported case of a ball thrombus in a hemodialysis patient who had previously undergone mitral valve replacement.
Kaneda
Toshio
T
Department of Cardiovascular Surgery, Kinki University School of Medicine, Osaka, Japan. toshio_kaneda@hotmail.com
Iemura
Junzo
J
Michihata
Iwao
I
Zhang
Zhi-Wei
ZW
Oka
Hiroshi
H
Otaki
Masaki
M
Saga
Toshihiko
T
D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000601:surgery; D017131:Thrombectomy; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography