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[Two cases of mitral stenosis associated with ball thrombus in the left atrium]
J Egami1, T Koishizawa, Y Watanabe
1Department of Cardiovascular Surgery, Kyorin University, School of Medicine, Mitaka, Japan.
Insights
Urgent removal of left atrial ball thrombus is crucial for patients with mitral stenosis to prevent potentially fatal systemic embolization and sudden death. Prompt surgical intervention after diagnosis significantly improves patient outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Surgery
Background:
- Mitral stenosis is a significant valvular heart disease.
- Left atrial ball thrombus formation is a rare but serious complication.
- Systemic arterial embolism can lead to severe neurological and systemic events.
Observation:
- Two female patients, aged 55 and 77, presented with mitral stenosis and left atrial ball thrombus.
- One patient experienced cerebral infarction, and the other had a syncopal attack, both indicative of systemic arterial embolism.
- Echocardiography confirmed the presence of ball thrombi.
Findings:
- Both patients underwent urgent surgical removal of the ball thrombi.
- Other procedures included open mitral commissurotomy (OMC) and mitral valve replacement (MVR).
- Post-operative outcomes were positive, with no further embolic events reported.
Implications:
- Left atrial ball thrombus in mitral stenosis poses a high risk of "hole in one sudden death" and recurrent embolization.
- Urgent surgical intervention for ball thrombus removal is strongly recommended upon diagnosis.
- Timely management can prevent catastrophic embolic events and improve survival rates.
Abstract:
Two patients (55-year-old female and 77-year-old female) were operated on for mitral stenosis associated with left atrial ball thrombus. The first case had the episode of cerebral infarction and second case had syncopal attack. Both of them presented with systemic arterial embolism. After confirmation of the diagnosis by echocardiography, removal of ball thrombi, OMC and MVR were carried out urgently. Considering high risk of "hole in one sudden death" and multiple-episodes of systemic embolization, ball thrombus should be removed as urgent following confirmation of diagnosis.