Surgical technique for massive mural thrombus in the left atrium

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Thrombosis Research

Background:

• Massive mural thrombus in the left atrium is a rare complication often associated with valvular heart disease.
• Left atrial thrombi pose a significant risk of systemic thromboembolism, particularly during cardiac surgery.
• Existing surgical strategies for managing left atrial thrombi have limitations in preventing recurrence and perioperative complications.

Observation:

• A surgical case involving a massive mural thrombus in the left atrium secondary to valvular heart disease is described.
• The surgical intervention included the removal of the mural thrombus.
• Fresh autologous pericardium was utilized to resurface the denuded left atrial endocardium.

Findings:

• The application of autologous pericardium created a smooth surface on the left atrial endocardium.
• This technique effectively addressed the roughened endocardial surface post-thrombus removal.
• The procedure demonstrated potential for mitigating perioperative risks and long-term thrombus formation.

Implications:

• This surgical approach may offer a novel method for managing complex left atrial thrombi in patients with valvular heart disease.
• Utilizing autologous pericardium could reduce the incidence of perioperative thromboembolic events.
• The creation of a smooth endocardial surface may prevent future thrombus development, improving long-term patient outcomes.