title: Protruding thrombus in the left atrium found 7 years after percutaneous transvenous mitral commissurotomy: report of a case.
abstract: A 50-year-old man was transferred to our hospital for investigation of cerebellar infarction, thought to have been caused by cardiac thromboembolism. We assumed that the cardiac thromboembolism had occurred as a late complication of a percutaneous transvenous mitral commissurotomy (PTMC) performed 7 years earlier. An echocardiogram and thoracic computed tomography revealed a protruding thrombus in the left atrium and an emergency operation was performed. The protruding thrombus was found to originate from the scar that penetrated into the intra-atrial muscular septum caused by the PTMC. After removing the thrombus, the scar was covered with normal endothelium and the mitral valve was replaced with a 27-mm St. Jude Medical prosthetic valve. We think that the thromboembolism was caused by mitral valve restenosis, atrial fibrillation, and endothelial injury in the interatrial septum during PTMC. Therefore, long-term follow-up and appropriate medication is recommended after PTMC, since restenosis and thrombosis are likely to occur.
authors.affiliation: Department of Cardiovascular Surgery, Nobeoka Prefectural Hospital, 2-1-10 Shinkouji, Nobeoka, Miyazaki 882-0835, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Furukawa
authors.forename: Masachika
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Eisaku
authors.initials: E
authors.lastname: Nakamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Ninomiya
authors.forename: Toshio
authors.initials: T
authors.lastname: Onitsuka
mesh_terms: D002544:Cerebral Infarction / Q000209:etiology; D004452:Echocardiography; D006325:Heart Atria / Q000473:pathology*; D006331:Heart Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011183:Postoperative Complications; D013923:Thromboembolism / Q000150:complications / Q000209:etiology; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D013997:Time Factors