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High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
09:17

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A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole

Mikiko Fujiwara1, Hiroyuki Watanabe, Yasunori Oguma

  • 1Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Hondoh 1-1-1, Akita 010-8543, Japan.

Heart and Vessels
|November 3, 2011
PubMed

Insights

A rare free-floating left atrial thrombus in a patient with atrial fibrillation was observed to intermittently entrap in the ventricle. Urgent surgical removal was successful, highlighting a unique clinical presentation.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Internal Medicine

Background:

  • Free-floating left atrial thrombi are uncommon cardiac presentations.
  • Atrial fibrillation increases the risk of thrombus formation and embolism.

Observation:

  • A 75-year-old woman with atrial fibrillation presented with acute myocardial infarction.
  • Incidental echocardiography revealed a free-floating left atrial thrombus.
  • The thrombus demonstrated intermittent entrapment in the mid-ventricle during diastole post-percutaneous coronary intervention.

Findings:

  • The left atrial thrombus exhibited dynamic movement, entrapping in the ventricle and rebounding into the atrium.
  • Surgical excision revealed a pedunculated, laminated thrombus with an onion-skin appearance, differing from the initial echocardiographic spherical assessment.
  • Urgent surgical removal was successfully performed.

Implications:

  • This case highlights a rare but potentially life-threatening complication of left atrial thrombi.
  • The dynamic behavior of the thrombus underscores the importance of prompt diagnosis and intervention.
  • Understanding the morphology of such thrombi is crucial for surgical planning and patient management.

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