title: Left atrium ball thrombus in a patient with hemorrhagic cerebral infarction.
abstract: The patient was a 72-year-old man with left hemiparesis. Multiple hemorrhagic cerebral infarctions were recognized on a computed tomographic (CT) scan. A transesophageal echocardiogram showed a huge left atrial mass, which was floating and nearly obstructed the mitral orifice in the diastolic phase. Emergency left atrial mass removal was performed. To reduce the risk of critical brain hemorrhage, the dose of heparin was reduced (100 U/kg) and 1 mg/kg/h of nafamostat mesilate was administered into the venous circuit during extracorporeal circulation. A postoperative brain CT scan showed no evidence of deterioration of cerebral hemorrhage. Pathologic examination showed a ball thrombus.
authors.affiliation: Department of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Yasuda
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Tokunaga
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsuki
authors.forename: Hironao
authors.initials: H
authors.lastname: Okamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Machida
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D001550:Benzamidines; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002544:Cerebral Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005341:Fibrinolysin / Q000037:antagonists & inhibitors; D006146:Guanidines / Q000008:administration & dosage; D006325:Heart Atria; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D008297:Male; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; D005341:Fibrinolysin; C032855:nafamostat
keywords: 18