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Published on: June 11, 2019

Floating ball thrombus in the left atrium with mitral stenosis

Takahiko Misumi1, Mikihiko Kudo, Tsutomu Ito

  • 1Division of Cardiovascular Surgery, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|September 10, 2003
PubMed

Insights

A rare case of a floating ball thrombus in the left atrium causing cerebral infarction is presented. This unusual cardiac thrombus required surgical removal and mitral valve replacement.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Neurology

Background:

  • Mitral stenosis is a common valvular heart disease.
  • Atrial fibrillation and left atrial mural thrombi are known complications of mitral stenosis.
  • Cerebral infarction can be caused by cardioembolic events.

Observation:

  • A 76-year-old woman with a history of mitral stenosis presented with right cerebral infarction.
  • Echocardiography revealed a mobile, spherical thrombus (30x30x30 mm) in the left atrium.
  • The patient also had atrial fibrillation and a pre-existing left atrial mural thrombus.

Findings:

  • The left atrial ball thrombus was surgically removed concurrently with mitral valve replacement.
  • The thrombus was described as single, round, soft, and smooth-surfaced.
  • Postoperative recovery was uneventful.

Implications:

  • Left atrial ball thrombi are uncommon but pose a significant embolic risk.
  • This case highlights the potential for mural thrombi to embolize and form mobile ball thrombi.
  • Prompt diagnosis and surgical intervention are crucial for managing such rare cardiac emergencies.

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