title: [Acute abdominal aortic occlusion in a patient with a giant thrombus in the left atrium and mitral stenosis; report of a case].
abstract: The patient was a 69-year-old male who had had percutaneous transvenous mitral commissurotomy (PTMC) 15 years ago, and had stopped taking warfarin after PTMC. He was transferred to our emergency room( ER) because of sudden severe pain in his both lower legs. We recognized pulselessness in his both femoral arteries, and pallor, paresthesia and poikilothermia in his lower extremities. Electorocardiogram(ECG) showed arterial fibrillation, and computed tomography( CT) showed occlusion of the abdominal aorta just below inferior mesenteric artery( IMA) and both common iliac arteries. By echocardiography, a giant thrombus was detected in the left atrium with severe mitral stenosis. Thrombectomy and angioplasty were performed at about 5 hours after the onset of occlusion, and revascularization was successful. Three days after the operation, we excised the giant thrombus in the left atrium and performed mitral valve replacement because we considered that myonephropathic metabolic syndrome (MNMS) had been prevented. The postoperative course was uneventful and he was discharged on the 27th postoperative day.
authors.affiliation: Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ono
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Endo
authors.forename: Tokuichiro
authors.initials: T
authors.lastname: Nagata
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Chiba
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Ono
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Kitanaka
authors.forename: Masahide
authors.initials: M
authors.lastname: Chikada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishimaki
authors.forename: Haruo
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000208:Acute Disease; D000368:Aged; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000150:complications*; D006325:Heart Atria; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000209:etiology*; D013927:Thrombosis / Q000150:complications*