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[Four successfully operated cases of ball thrombus in the left atrium]
Insights
Left atrial ball thrombus, often linked to mitral stenosis, can cause syncope and embolism. Urgent surgical removal is crucial due to high risks of sudden death and peripheral embolism.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Mitral stenosis is a significant cardiac condition.
- Left atrial ball thrombus is a rare but serious complication.
Observation:
- Four cases of left atrial ball thrombus associated with mitral stenosis were reported.
- Three patients presented with syncopal attacks and systemic embolism.
- Echocardiography proved highly effective for preoperative diagnosis.
Findings:
- Urgent surgical intervention, including thrombus removal and mitral valve repair or replacement, was performed.
- Specific surgical positioning and cardiopulmonary bypass techniques were employed.
- No intraoperative complications were noted.
Implications:
- Early diagnosis and urgent surgical management of left atrial ball thrombus are critical.
- Prompt intervention can prevent life-threatening events like embolism and sudden death.
- This highlights the importance of echocardiography in diagnosing complex cardiac masses.
Abstract:
The authors report four cases of the left atrial ball thrombus associated with mitral stenosis. Three of four which had floating ball thrombus in the left atrium presented with syncopal attacks and systemic embolism. Echocardiography was the most effective method for preoperative diagnosis of ball thrombus in the left atrium and mitralstenosis. After having accurate diagnosis of ball thrombus in the left atrium by echocardiogram, all of cases were treated urgently with removal of the thrombus and mitral valve replacement or mitral commissurotomy. During operation, the head down position and slight right lateral position had been maintained to prevent the impaction of the ball thrombus into mitral valve orifice and the immediate cardiopulmonary bypass by ascending aortic, superior and inferior venous cannulation were placed through midsternal splitting incision. Because of high frequency of peripheral embolism and sudden death, left atrial ball thrombus should be recommended to be removed urgently.