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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Giant left atrial ball thrombus in a patient with chronic nonvalvular atrial fibrillation

Jae Hoon Lee1, Shin Kwang Kang, Cheol Whan Lee

  • 1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

The Annals of Thoracic Surgery
|December 25, 2007
PubMed

Insights

A patient with atrial fibrillation experienced cardiac arrest during an MRI, revealing multiple brain emboli. Emergency surgery successfully removed a left atrial thrombus, leading to an uneventful recovery.

Area of Science:

  • Cardiology
  • Neurology
  • Cardiovascular Surgery

Background:

  • Chronic nonvalvular atrial fibrillation poses a significant risk for thromboembolic events.
  • Magnetic resonance imaging (MRI) can precipitate cardiovascular events in susceptible patients.
  • Prompt diagnosis and intervention are crucial for managing embolic stroke secondary to cardiac thrombi.

Observation:

  • A 56-year-old woman with atrial fibrillation suffered cardiac arrest during an MRI.
  • Post-resuscitation brain MRI showed multiple embolic lesions.
  • Transesophageal echocardiography identified a large left atrial free-floating thrombus and mural thrombi.

Findings:

  • Despite a recent stroke, emergency surgery was performed due to the high-risk thrombus.
  • The surgical removal of the left atrial thrombus was successful.
  • The patient experienced an uneventful postoperative recovery and remains well at 8-month follow-up.

Implications:

  • This case highlights the potential for cardiac events during MRI in patients with atrial fibrillation.
  • Early surgical intervention for large atrial thrombi, even after a recent stroke, can be life-saving.
  • Effective management of atrial fibrillation and prompt treatment of embolic complications are vital.

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