title: Frequency of left atrial and appendage clot in patients with severe mitral stenosis.
abstract: BACKGROUND
  Left atrial thrombus is common in patients with mitral stenosis and atrial fibrillation; but how frequent it is in our population? The objective of study was to see the frequency of left atrial and appendage clot on trans-oesophageal echocardiography in symptomatic patients with severe mitral stenosis planned for PTMC.
  
  
  METHODS
  Trans-oesophageal echocardiographic data retrieved from computer database Cardiology department, Lady Reading Hospital, Peshawar from August 1998 to Mach 2008. Patients admitted for PTMC under went trans-oesophageal echocardiography for detection of left atrial and appendage clot and quantification of mitral regurgitation. Data was analyzed on SPSS.
  
  
  RESULTS
  Out of 1544 patients, males were 608 (39.4%), females were 936 (60.6%). Mean age was 30.84 +/- 12.6. Mean age of males was 30.56 +/- 13.1 years and females were 31.02 +/- 12.6 years. Minimum age was 8 years and maximum was 76 years. The mean LA size was 43.82 +/- 2.12 mm.Atrial fibrillation was observed in 289 (18.7%).Overall clot was seen in 224 (14.5%) patients. Left atrial appendage clot seen in 202 (89.73%).LA clot seen in 9 (4.02%). LAA/LA clot seen in 14 (6.25%). No significant difference was observed for clot among the gender distribution (p=0.42). Significant correlation was observed for clot in patients with AF and LA size > or = 45 mm, (p>0.001).
  
  
  CONCLUSIONS
  The frequency of left atrial and appendage clots on trans-oesophageal echocardiography in patients with severe mitral stenosis is common and more frequent in patients with AF and LA size > or = 45 mm.
authors.affiliation: Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan. mahmoodlrh@yahoo.com
authors.lastname: Mahmood ul Hassan
authors.forename: Cheragh
authors.initials: C
authors.lastname: Hussain
authors.forename: Adnan Mahmood
authors.initials: AM
authors.lastname: Gul
authors.forename: Hikmat
authors.initials: H
authors.lastname: ullah Jan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hafizullah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020517:Atrial Appendage; D002648:Child; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult