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Trombos Gigante Flotante en la Aurícula Izquierda tras Cierre Incompleto de la Apófisis Auricular Izquierda por

Motoki Nagatsuka¹, Tohru Asai¹, Kenichiro Noguchi¹

¹Department of Cardiovascular Surgery, Shonan Kamakura General Hospital.

The Annals of thoracic surgery

|January 26, 2026

Abstract:

A 79-year-old man with permanent atrial fibrillation and cardiomyopathy had previously received an implantable cardioverter-defibrillator. Despite anticoagulation, he had experienced three cerebral infarctions and underwent thoracoscopic left atrial appendage closure (LAAC). Transthoracic echocardiography on postoperative day 5 revealed free-floating thrombus in the left atrium, prompting emergency surgical removal and tricuspid valve repair. Incomplete exclusion of the appendage was identified as a key procedural pitfall leading to thrombus formation. Concomitant severe tricuspid regurgitation may have contributed to atrial stasis. In patients with markedly impaired atrial hemodynamics, concomitant tricuspid valve repair at LAAC may help mitigate the risk of thrombus formation.

Palabras clave:

trombo relacionado con dispositivo trombo en bola flotante cierre de apófisis auricular izquierda por toracoscopia

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