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Left atrial thrombosis following mitral valve repair and maze procedure: case report

Shigeaki Aoyagi1, Eiki Tayama, Shuji Fukunaga

  • 1Department of Surgery, Kurume University School of Medicine, Kurume, Japan.

The Journal of Heart Valve Disease
|December 9, 2003
PubMed

Insights

This case study highlights left atrial thrombosis after mitral valve repair and maze procedure. Surgical removal of the thrombus successfully resolved the complication, preventing recurrence.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Mitral valve repair and Kosakai-maze procedures are complex cardiac surgeries.
  • Post-operative complications like thrombosis can occur despite successful initial repair.

Observation:

  • A 71-year-old woman developed left atrial thrombosis three months after mitral valve repair and Kosakai-maze procedure.
  • Suboptimal anticoagulation levels and positive anticardiolipin antibodies were noted.
  • Initial anticoagulation therapy with heparin and warfarin was ineffective in reducing thrombus size.

Findings:

  • A large, adherent thrombus involving the Kosakai-maze incision line was identified during reoperation.
  • Complete surgical excision of the thrombus was achieved.
  • Post-reoperation anticoagulation with warfarin and antiplatelet agents maintained target INR levels.

Implications:

  • Surgical intervention is a viable option for managing persistent left atrial thrombosis post-cardiac surgery.
  • Aggressive anticoagulation and antiplatelet therapy are crucial for preventing recurrence.
  • This case underscores the importance of vigilant monitoring and management of anticoagulation in high-risk patients.

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