A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Free-floating ball thrombus in the left atrium is a rare condition.
• Diagnosis is aided by echocardiography and multi-detector row computed tomography (MDCT).

Observation:

• A 75-year-old woman with chronic atrial fibrillation, complete atrioventricular block, mitral regurgitation, and heart failure experienced recurrent giant spherical thrombi.
• Despite intensive anticoagulation, thrombi recurred three times in six months, necessitating surgical intervention.
• Even after surgical removal and left atrial appendage closure, a thrombus recurred three months later.

Findings:

• The case demonstrates the challenges in treating refractory left atrial thrombi.
• Recurrence of thrombi occurred despite multiple interventions, including anticoagulation and surgery.

Implications:

• This case underscores the complexity of managing persistent left atrial thrombi.
• Further research may be needed to explore novel therapeutic strategies for refractory cases.