Visualisation of left atrial thrombi by coronary arteriography

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Cardiac Surgery

Background:

• Mitral stenosis is a significant valvular heart disease.
• Left atrial appendage thrombus formation is a known complication.
• Diagnosing left atrial appendage thrombus can be challenging.

Purpose of the Study:

• To investigate the utility of coronary arteriography in detecting abnormalities in the left atrial appendage region in mitral stenosis patients.
• To correlate arteriographic findings with the presence of left atrial thrombi.

Main Methods:

• Coronary arteriography was performed in 5 patients with mitral stenosis.
• Abnormal vascularity in the left atrial appendage region was assessed.
• Surgical confirmation of left atrial thrombi was obtained in relevant cases.

Main Results:

• Abnormal vascularity in the left atrial appendage region was identified in all 5 patients.
• Three of these patients underwent surgery, and left atrial thrombi were confirmed in all three.
• Neovascularity requires differentiation from congenital fistulae, tumors, and coronary artery disease.

Conclusions:

• Coronary arteriography may demonstrate abnormal vascularity in the left atrial appendage in mitral stenosis.
• This finding can be associated with left atrial thrombi.
• Coronary arteriography can occasionally aid in the diagnosis of left atrial appendage thrombus, complementing other imaging modalities.