A safe technique for removal of massive left atrial thrombus

Open mitral operation in patients with massive left atrial thrombus still carries a high mortality due to intraoperative embolism. To prevent this danger, we have standardized a surgical technique that includes careful handling of the heart and use of suction, blockage of the mitral orifice, and excision of subendocardial thrombus. Our total experience with massive left atrial thrombosis comprises 30 patients. Seven out of 8 patients operated on before our present technique was used died in the hospital of irreversible cerebral damage. The other 22 patients underwent operation with this technique, and the thrombus was removed without mortality or morbidity.