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. 2017 Sep 20;5(11):1898-1900.
doi: 10.1002/ccr3.1187. eCollection 2017 Nov.

Catheter-related right atrial thrombus in sickle cell disease

Chen Zhao  1 , Bharath Sathya  2 , Rosa Nadal Rios  1 , Andrew E Arai  2 , Alessandra Brofferio  3 , Swee Lay Thein  4 , A Parker Ruhl  4
Affiliations

Catheter-related right atrial thrombus in sickle cell disease

Chen Zhao et al. Clin Case Rep. .

Abstract

Catheter-related right atrial thrombus (CRAT) can occur in patients with sickle cell disease, particularly if additional risk factors for thrombosis are present. Cardiac MRI may differentiate thrombi from other types of atrial masses. Treatment should include anticoagulation and the timing of catheter removal should balance the potential risk of embolization.

Keywords: Anticoagulation; MRI; catheter‐related right atrial thrombus; sickle cell disease.

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Figures

Figure 1
Figure 1
Transthoracic echocardiography. (A) Apical four‐chamber view demonstrates a mass in the right atrium (yellow arrow) (B) Parasternal short‐axis view with focus on the right atrium demonstrates a catheter tip is visible touching the mass (red arrow).
Figure 2
Figure 2
MRI characterization of right atrial thrombi. (A) A four‐chamber Steady‐State Free Precession (SSFP) cine shows three separate right atrial thrombi. There is thrombus associated with a catheter tip (red arrow). The largest thrombus is noted in the mid‐portion of the right atrium (blue arrow). Thrombus is also noted close to tricuspid valve (yellow arrow). (B) A four‐chamber fat‐suppressed double inversion recovery image excludes lipoma as an explanation for the mass. (C) A 4‐chamber perfusion image more clearly demonstrates low uptake of contrast compared to the blood pool. (D) Phase‐sensitive inversion recovery imaging shows minimal late gadolinium enhancement when compared to normal myocardium. These cardiac MRI findings are consistent with intracardiac thrombus and are not typical of myxoma or vegetation.
See this image and copyright information in PMC

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