title: Pinball-Like Free-Floating Left Atrial Ball Thrombus Presenting with Hemiplegia: A Challenging Treatment Decision.
abstract: We describe a case of a patient with a history of chronic atrial fibrillation who presented with sudden onset of left hemiplegia. Nine months earlier the longstanding warfarin therapy had been suspended due to a hemorrhagic stroke. Transthoracic echocardiography revealed a large free-floating highly mobile mass in the left atrium and severe mitral valve regurgitation. Due to the potential risk of an embolic event or a hemodynamic collapse, a decision to carry out an emergency operation was made irrespective of the neurological condition of the patient. Unfortunately, the patient died on the 18th postoperative day after a freshly occurring hemorrhagic stroke.
authors.affiliation: Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Demir
authors.affiliation: Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Mehmet Umit
authors.initials: MU
authors.lastname: Ergenoglu
authors.affiliation: Department of Anesthesiology, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Nursen
authors.initials: N
authors.lastname: Tanrikulu
authors.affiliation: Department of Cardiology, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Ahmet Yasar
authors.initials: AY
authors.lastname: Cizgici
authors.affiliation: Department of Cardiology, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Kemal Ilker
authors.initials: KI
authors.lastname: Yildirim
authors.affiliation: Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Demirsoy
mesh_terms: D000369:Aged, 80 and over; D020520:Brain Infarction / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006331:Heart Diseases / Q000150:complications* / Q000601:surgery*; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology; D013927:Thrombosis / Q000150:complications* / Q000601:surgery*