title: Diagnosis of a huge right atrial thrombus during coronary artery bypass graft surgery.
abstract: METHODS
  Male, 73 FINAL DIAGNOSIS: Coronary artery thrombosis Symptoms: Angina pectoris • short of breath
  
  
  METHODS
  - Clinical Procedure: CABG Specialty: Cardiology.
  
  
  OBJECTIVE
  Management of emergency care.
  
  
  BACKGROUND
  Intra-operative formation of a thrombus in the right heart is rare and might be unrecognized. However, it can be associated with severe consequences, including pulmonary embolism and death.
  
  
  METHODS
  We report the case of a 73-year-old man who presented to the cardiologist with angina pectoris and rare shortness of breath. Coronary artery bypass grafting (CABG) was performed due to multi-vessel disease. Because of hemodynamic insufficiency, an intra-operative transesophageal echocardiogram (TEE) was performed and a huge free-floating thrombus was detected. Multiple thrombi were removed from the right heart and pulmonary arteries. The patient died after cardiopulmonary bypass support and 12 hours of intensive care.
  
  
  CONCLUSIONS
  In this case report, we emphasize the importance of the TEE during the preoperational period and during CABG, as well as in the preoperative evaluation of pulmonary hypertension.
authors.affiliation: Department of Cardiology, Sifa University School of Medicine, Izmir, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Senarslan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Zungur
authors.forename: Ihsan Sami
authors.initials: IS
authors.lastname: Uyar
authors.forename: Samet
authors.initials: S
authors.lastname: Uyar
authors.forename: Talat
authors.initials: T
authors.lastname: Tavli
authors.forename: Emin Alp
authors.initials: EA
authors.lastname: Alayunt
keywords: coronary artery bypass grafting; intra-operative transesophageal echocardiography; thromboembolism