Skip to main content
Erschienen in: Heart and Vessels 4/2012

01.07.2012 | Case Report

A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole

verfasst von: Mikiko Fujiwara, Hiroyuki Watanabe, Yasunori Oguma, Genbu Yamaura, Kazuyuki Ishibashi, Hiroshi Yamamoto, Kiyoshi Nobori, Kenji Iino, Fumio Yamamoto, Hiroshi Ito

Erschienen in: Heart and Vessels | Ausgabe 4/2012

Einloggen, um Zugang zu erhalten

Abstract

Free-floating left atrial thrombi are rare. Here we report a case of a 75-year-old woman with atrial fibrillation who was admitted for treatment of acute myocardial infarction. A free-floating left atrial thrombus was found incidentally on echocardiography. Ten days after percutaneous coronary intervention, the patient had mild faintness with transient hypotension, and it was found that the left atrial thrombus had developed intermittent entrapment in the mid-ventricle during diastole, with abrupt rebound back to the left atrial cavity during systole. Urgent removal of the thrombus was performed successfully. Although the free-floating thrombus had appeared to be spherical, like a ball thrombus, on echocardiography, the excised thrombus was pedunculated. A cut section revealed a laminated thrombus with an onion-skin-like appearance.
Literatur
1.
Zurück zum Zitat Yeoh JK, Yan CH, Soo CS, Lim YT, Choo HH (1991) Mitral stenosis and free-floating left atrial thrombus: demonstration of the “hole-in-one” effect by color Doppler echocardiography. Am Heart J 121:1551–1552PubMedCrossRef Yeoh JK, Yan CH, Soo CS, Lim YT, Choo HH (1991) Mitral stenosis and free-floating left atrial thrombus: demonstration of the “hole-in-one” effect by color Doppler echocardiography. Am Heart J 121:1551–1552PubMedCrossRef
2.
Zurück zum Zitat Wrisley D, Giambartolomei A, Lee I, Brownlee W (1991) Left atrial ball thrombus: review of clinical and echocardiographic manifestations with suggestions for management. Am Heart J 121:1784–1790PubMedCrossRef Wrisley D, Giambartolomei A, Lee I, Brownlee W (1991) Left atrial ball thrombus: review of clinical and echocardiographic manifestations with suggestions for management. Am Heart J 121:1784–1790PubMedCrossRef
3.
Zurück zum Zitat Dembo DH, Cowley RA (1964) Left atrial thrombus with ball valve action. Arch Intern Med 114:139–144PubMedCrossRef Dembo DH, Cowley RA (1964) Left atrial thrombus with ball valve action. Arch Intern Med 114:139–144PubMedCrossRef
4.
Zurück zum Zitat Fraser AG, Angelini GD, Ikram S, Butchart EG (1988) Left atrial ball thrombus: echocardiographic features and clinical implications. Eur Heart J 9:672–677PubMed Fraser AG, Angelini GD, Ikram S, Butchart EG (1988) Left atrial ball thrombus: echocardiographic features and clinical implications. Eur Heart J 9:672–677PubMed
5.
Zurück zum Zitat Kim MS, Park JH, Kang SK, Na MH, Lee JH, Choi SW, Jeong JO, Seong IW (2009) Acute ST-segment elevation myocardial infarction due to a huge floating thrombus mimicking a myxoma in the left atrium. J Am Soc Echocardiogr 22:1085.e1–1085.e3 Kim MS, Park JH, Kang SK, Na MH, Lee JH, Choi SW, Jeong JO, Seong IW (2009) Acute ST-segment elevation myocardial infarction due to a huge floating thrombus mimicking a myxoma in the left atrium. J Am Soc Echocardiogr 22:1085.e1–1085.e3
6.
Zurück zum Zitat Devigne M, Vermeersch P, van den Heuvel P (2004) Thrombus-in-transit causing paradoxical embolism in cerebral and coronary arterial circulation. Acta Cardiol 59:669–672 Devigne M, Vermeersch P, van den Heuvel P (2004) Thrombus-in-transit causing paradoxical embolism in cerebral and coronary arterial circulation. Acta Cardiol 59:669–672
7.
Zurück zum Zitat Tarsia G, Michele MD, Polosa D, Biondi-Zoccai G, Costantino F, Prete GD, Osanna RA, Innelli P, Sisto F, Sheiban I, Lisanti P (2010) Manual versus nonmanual thrombectomy in primary and rescue percutaneous coronary angioplasty. Heart Vessels 25:275–281PubMedCrossRef Tarsia G, Michele MD, Polosa D, Biondi-Zoccai G, Costantino F, Prete GD, Osanna RA, Innelli P, Sisto F, Sheiban I, Lisanti P (2010) Manual versus nonmanual thrombectomy in primary and rescue percutaneous coronary angioplasty. Heart Vessels 25:275–281PubMedCrossRef
8.
Zurück zum Zitat Vink MA, Patterson MS, van Etten J, Ijsselmuiden AJJ, Dirksen MT, Amoroso G, Slagboom T, Laarman GJ, Kiemeneij F (2011) A randomized comparison of manual versus mechanical thrombus removal in primary percutaneous coronary intervention in the treatment of ST-segment elevation myocardial infarction (TREAT-MI). Catheter Cardiovasc Interv 78:14–19PubMedCrossRef Vink MA, Patterson MS, van Etten J, Ijsselmuiden AJJ, Dirksen MT, Amoroso G, Slagboom T, Laarman GJ, Kiemeneij F (2011) A randomized comparison of manual versus mechanical thrombus removal in primary percutaneous coronary intervention in the treatment of ST-segment elevation myocardial infarction (TREAT-MI). Catheter Cardiovasc Interv 78:14–19PubMedCrossRef
9.
Zurück zum Zitat Monopoli DE, Politi L, Sgura F, Rossi R, Modena MG, Sangiorgi GM (2011) Acute myocardial infarction with occlusion of all three main epicardial coronary arteries: when Mother Nature takes care more than physicians. Heart Vessels 26:222–225PubMedCrossRef Monopoli DE, Politi L, Sgura F, Rossi R, Modena MG, Sangiorgi GM (2011) Acute myocardial infarction with occlusion of all three main epicardial coronary arteries: when Mother Nature takes care more than physicians. Heart Vessels 26:222–225PubMedCrossRef
10.
Zurück zum Zitat Ruiz-Nodar JM, Martin F, Hurtado A, Valencia J, Pinar E, Pineda J, Gimeno JR, Sogorb F, Valdes M, Lip GYH (2008) Anticoagulant and antiplatelet therapy use in 426 patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation: implications for bleeding risk and prognosis. J Am Coll Cardiol 51:818–825PubMedCrossRef Ruiz-Nodar JM, Martin F, Hurtado A, Valencia J, Pinar E, Pineda J, Gimeno JR, Sogorb F, Valdes M, Lip GYH (2008) Anticoagulant and antiplatelet therapy use in 426 patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation: implications for bleeding risk and prognosis. J Am Coll Cardiol 51:818–825PubMedCrossRef
Metadaten
Titel
A free-floating left atrial thrombus develops intermittent entrapment in the mid-ventricle during diastole
verfasst von
Mikiko Fujiwara
Hiroyuki Watanabe
Yasunori Oguma
Genbu Yamaura
Kazuyuki Ishibashi
Hiroshi Yamamoto
Kiyoshi Nobori
Kenji Iino
Fumio Yamamoto
Hiroshi Ito
Publikationsdatum
01.07.2012
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 4/2012
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-011-0199-0

Weitere Artikel der Ausgabe 4/2012

Heart and Vessels 4/2012 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.