Related Experiment Video
Updated: Mar 14, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Right atrial mural thrombi: An autopsy study of an under-diagnosed complication at an unusual site
P Vaideeswar1, J Chaudhari2, N Karnik2
1Department of Pathology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, Maharashtra, India.
Background:
Right atrial mural thrombi (RAMT) are often seen in association with cardiac diseases or foreign bodies. Unusual locations at the flutter isthmus and the atrial appendage prompted us to evaluate our 2-year autopsy data on such thrombi.
Materials And Methods:
In the 2-year retrospective autopsy, the clinical and autopsy records of patients with RAMT were reviewed, with particular reference to the presence of central venous catheter (CVC), its site of insertion, its type, material and size, its duration of placement, and the drugs infused through the catheter.
Results:
Of the 940 autopsies performed in 2 years, RAMT was seen in 24 hearts and was related to an insertion of a CVC in 23 patients (95.8%). The risk and/or associated factors for this complication were tunneled and polyethylene catheters, Intensive Care Unit admission, infused drugs, underlying cardiac diseases, and pregnancy. A noteworthy feature was the location of the thrombi in the flutter isthmus in 16 hearts (66.7%) and atrial appendage in another six hearts. Localized endocarditis/myocarditis and pulmonary thromboembolism were observed in six and four patients, respectively.
Conclusions:
This autopsy study, which has a high incidence of catheter-related RAMT, does not reflect the true incidence but reiterates the importance of guided insertion of central venous and prompt recognition of thrombus formation.
Insights
Right atrial mural thrombi (RAMT) are strongly linked to central venous catheters (CVCs). This autopsy study highlights the importance of careful CVC insertion and early detection of thrombus formation to prevent complications.
Area of Science:
- Cardiovascular Pathology
- Medical Device Complications
Background:
- Right atrial mural thrombi (RAMT) are typically associated with cardiac conditions or foreign bodies.
- Unusual thrombi locations, such as the flutter isthmus and atrial appendage, prompted this investigation.
Purpose of the Study:
- To evaluate the association between central venous catheters (CVCs) and right atrial mural thrombi (RAMT) using autopsy data.
- To identify risk factors and common locations of catheter-related RAMT.
Main Methods:
- A retrospective review of 940 autopsy cases over a 2-year period.
- Analysis of clinical and autopsy records for patients with RAMT, focusing on CVC details (insertion site, type, duration, infused drugs).
Main Results:
- RAMT was identified in 24 hearts (2.55%), with 95.8% linked to CVC insertion.
- Tunneled polyethylene catheters, ICU admission, infused drugs, cardiac disease, and pregnancy were identified as risk factors.
- Thrombi were frequently located at the flutter isthmus (66.7%) and atrial appendage (25%). Localized endocarditis/myocarditis and pulmonary thromboembolism were also observed.
Conclusions:
- The study indicates a high incidence of catheter-related RAMT in autopsies, emphasizing the need for guided CVC insertion.
- Prompt recognition and management of thrombus formation are crucial for preventing serious complications.
More Related Videos
04:29Author Spotlight: Advancements in Intracardiac Echocardiography for Atrial Anatomy Assessment
Published on: June 30, 2023
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022