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Frequency of left atrial and appendage clot in patients with severe mitral stenosis

Mahmood ul Hassan1, Cheragh Hussain, Adnan Mahmood Gul

  • 1Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan. mahmoodlrh@yahoo.com

Journal of Ayub Medical College, Abbottabad : JAMC
|June 28, 2011
PubMed

Insights

Left atrial and appendage clots are common in patients with severe mitral stenosis, particularly those with atrial fibrillation and larger left atrial size. Trans-oesophageal echocardiography is key for detection.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Left atrial thrombus is a known complication in patients with mitral stenosis and atrial fibrillation.
  • The prevalence of left atrial and appendage clots in this specific population in Pakistan was not well-defined.

Purpose of the Study:

  • To determine the frequency of left atrial and appendage clots.
  • To assess these clots in symptomatic patients with severe mitral stenosis undergoing percutaneous trans-mitral commissurotomy (PTMC).

Main Methods:

  • Retrospective analysis of trans-oesophageal echocardiography (TOE) data from August 1998 to March 2008.
  • Data from 1544 patients with severe mitral stenosis planned for PTMC were reviewed.
  • TOE was used to detect left atrial and appendage clots and quantify mitral regurgitation.

Main Results:

  • A total of 1544 patients were analyzed; 14.5% had clots.
  • Left atrial appendage clots were more common (89.73% of all clots).
  • Clot prevalence was significantly higher in patients with atrial fibrillation and left atrial size >= 45 mm (p>0.001).

Conclusions:

  • Left atrial and appendage clots are frequent in patients with severe mitral stenosis.
  • The presence of atrial fibrillation and larger left atrial size are significant risk factors for clot formation.
Abstract

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