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Pinball-Like Free-Floating Left Atrial Ball Thrombus Presenting with Hemiplegia: A Challenging Treatment Decision

Tolga Demir1, Mehmet Umit Ergenoglu1, Nursen Tanrikulu2

  • 1Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul, Turkey.

The Heart Surgery Forum
|January 5, 2016
PubMed

We describe a case of a patient with a history of chronic atrial fibrillation who presented with sudden onset of left hemiplegia. Nine months earlier the longstanding warfarin therapy had been suspended due to a hemorrhagic stroke. Transthoracic echocardiography revealed a large free-floating highly mobile mass in the left atrium and severe mitral valve regurgitation. Due to the potential risk of an embolic event or a hemodynamic collapse, a decision to carry out an emergency operation was made irrespective of the neurological condition of the patient. Unfortunately, the patient died on the 18th postoperative day after a freshly occurring hemorrhagic stroke.

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