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. 2021 Apr 30;2021(1):e202108.
doi: 10.21542/gcsp.2021.8.

A case of left atrial free ball thrombus in a patient with prosthetic mitral valve

Ahmed Mohamed Fawzy Ellaien  1
Affiliations

A case of left atrial free ball thrombus in a patient with prosthetic mitral valve

Ahmed Mohamed Fawzy Ellaien. Glob Cardiol Sci Pract. .

Abstract

A free left atrial ball thrombus is relatively a rare diagnosis and usually leads to systemic embolization or fatal complication of thrombus incarceration in left ventricle inflow. We report a case of 52-year-old woman who was admitted to hospital with symptoms of heart failure. Routine echocardiography showed a free-floating ball thrombus in the left atrium. The free-floating thrombus was round with smooth surface and about 37 mm in diameter. The mitral valve prosthesis was well-functioning. The computed tomography of the patient also showed the left atrial ball thrombus. The erratic finding was that the patient was compliant on oral anticoagulants for the last 6 months with her INR in theraputic range. This suggested that this thrombus had been there for a some time and anticoagulants failed to resolve this problem. She was referred to cardiac surgery for thrombus extraction but the patient refused to have the operation.

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Figures

Figure 1.
Figure 1.. Chest x-ray showing enlarged LA, biventricular enlargement, and pulmonary venous congestion.
Figure 2a.
Figure 2a.. Transthoracic echocardiography.
Apical 4-chamber view showed large freely mobile ball thrombus 37 mm in diameter floating in dilated LA. LA =left atrium, LV =left ventricle, RA =right atrium, RV =right ventricle.
Figure 2b.
Figure 2b.. Parasternal long axis view, showing the same ball thrombus with the same dimensions.
Figure 3a.
Figure 3a.. Computed tomography of the patient showing dilated cardiac chambers and round mass in the LA.
Figure 3b.
Figure 3b.. Computed tomography of the patient showed dilated cardiac chambers and round mass in the LA.
See this image and copyright information in PMC

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