Related Experiment Videos
[Surgical treatment of atrial thrombosis. A transesophageal echocardiogram study]
1Dipartimento di Medicina Interna, Divisione Universitaria di Cardiologia, Università degli Studi di Torino, Turin, Italy.
Insights
Transesophageal echocardiogram effectively diagnoses atrial thrombosis, including free-floating thrombi and masses on catheters or Chiari
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Surgery
Background:
- Transesophageal echocardiogram (TEE) is the gold standard for evaluating cardiac chamber masses.
- Atrial thrombosis presents unique diagnostic and therapeutic challenges.
Observation:
- Presents three distinct cases of atrial thrombosis: a mobile left atrial thrombus in mitral stenosis, catheter-associated thrombi, and thrombi on Chiari's network post-atrial septal defect repair.
- TEE was crucial in diagnosing all cases, revealing thrombus location, size, and mobility.
Findings:
- Medical management proved insufficient for these atrial thrombosis cases.
- Surgical thrombectomy was necessary for successful treatment and prevention of embolism.
Implications:
- TEE is vital for accurate diagnosis of complex atrial thrombosis.
- Surgical intervention is indicated for inadequate medical therapy, recurrent thrombosis, catheter infections, and high embolism risk.
Abstract:
Transesophageal echocardiogram is the procedure of choice in the evaluation of masses located in the cardiac chambers. In this paper three cases of atrial thrombosis are presented: a) a free floating ball thrombus in the left atrium in a patient with moderate mitral stenosis; b) three thrombotic masses adherent to a central venous catheter; c) three thrombotic masses attached to Chiari s network in a patient operated for an ostium secundum atrial septal defect one year before. In all cases transesophageal echocardiogram has played a key role in the diagnosis. Medical therapy has been inadequate and so surgical removal has been performed. Unsuccessful medical therapy, a new episode of thrombosis, intracardiac permanent catheter infections and high risk of systemic and pulmonary embolism are indications for thrombectomy.