scholarly journals Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant

Medicine ◽  
2021 ◽  
Vol 100 (23) ◽  
pp. e26137
Author(s):  
Myriam D’Angelo ◽  
Roberta Manganaro ◽  
Ilaria Boretti ◽  
Daniele Giacopelli ◽  
Gaetano Cannavà ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intracardiac Thrombus ◽  
Mitral Bioprosthesis

Use of Cardiac Tomography and Cardiac Magnetic Resonance to Predict the Absence of Intracardiac Thrombus in Anticoagulated Patients Undergoing Atrial Fibrillation Ablation.

2021 ◽  
Author(s):  
Fatima Zaraket ◽  
Bas Deva ◽  
Jesus jimenez ◽  
Benjamin Casteigt ◽  
Begoña Benito ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Pulmonary Veins ◽  
Intracardiac Thrombus ◽  
Ablation Procedure ◽  
Recurrent Atrial Fibrillation ◽  
Rule Out

Abstract Background: Pulmonary veins isolation (PVI) is a standard treatment for recurrent atrial fibrillation (AF). Uninterrupted anticoagulation for minimum 3 weeks before the ablation and exclusion of left atrial (LA) thrombus with transesophageal echography (TEE) immediately before or during the procedure minimize peri-procedural risk. We aimed to demonstrate the utility of cardiac tomography (CT) and cardiac magnetic resonance (CMR) to rule out LA thrombus prior to PVI.Methods: Patients undergoing PVI for recurrent AF were retrospectively evaluated. Only patients that started anticoagulation at least 3 weeks prior to the CT/CMR and subsequently uninterrupted until the ablation procedure were selected. An intracardiac echo (ICE) catheter was used in all patients to evaluate LA thrombus. The results of CT/CMR were compared to ICE imaging.Results: We included 272 consecutive patients averaging 54.5 years (71% male; 30% persistent AF). Average CHA2DS2VASC Score was 0.9 and mean LA diameter was 43 mm, 111 patients on Acenocumarol and 161 on direct oral anticoagulants. Anticoagulation was started 227±392 days before the CT/CMR, and 291±416 days before the ablation procedure. CT/CMR diagnosed intracardiac thrombus in 2 cases, both in the LA appendage. A new CT/CMR revealed resolution of thrombus after 6 additional months of uninterrupted anticoagulation. No macroscopic thrombus was observed in any patients with ICE (negative predictive value of 100%; p<0.01).Conclusions: CT and MRI are excellent surrogates to TEE and ICE to rule out intracardiac thrombus in patients adequately anticoagulated prior AF ablation. This is true even for delayed procedures as long as anticoagulation is uninterrupted.

Uninterrupted dabigatran versus warfarin in the treatment of intracardiac thrombus in patients with non-valvular atrial fibrillation

2015 ◽  
Vol 190 ◽  
pp. 63-66 ◽  
Author(s):  
Li Hao ◽  
Jing-quan Zhong ◽  
Wei Zhang ◽  
Bing Rong ◽  
Fei Xie ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intracardiac Thrombus

scholarly journals First mitral valve replacement using Edwards MITRIS RESILIA mitral valve in a patient with functional mitral regurgitation: a case report

2021 ◽  
Author(s):  
Takashi Kakuta ◽  
Tomoyuki Fujita ◽  
Satoshi Kainuma ◽  
Naonori Kawamoto ◽  
Naoki Tadokoro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Functional Mitral Regurgitation ◽  
Postoperative Course ◽  
Structural Valve Deterioration ◽  
History Of ◽  
Mitral Surgery ◽  
Mitral Bioprosthesis

RESILIA tissue expected to prevent structural valve deterioration owing to calcification on leaflets was firstly mounted in a mitral bioprosthesis, named MITRIS RESILIA mitral valve (MITRIS). MITRIS has softer cuff than Magna Mitral Ease and stent posts that deflect to prevent suture looping. A 77-year-old man, having a history of long-standing atrial fibrillation, presented with dyspnea on effort. An echocardiography suggested atrial functional MR. We successfully replaced mitral valve using a 27-mm MITRIS, and his postoperative course was uneventful with good hemodynamics. MITRIS may have advantages for implantability and durability, making it a promising prosthesis for patients requiring mitral surgery.

scholarly journals Cardiac Tomography and Cardiac Magnetic Resonance to Predict the Absence of Intracardiac Thrombus in Anticoagulated Patients Undergoing Atrial Fibrillation Ablation.

2021 ◽  
Author(s):  
Fatima Zaraket ◽  
Bas Deva ◽  
Jesus Jimenez ◽  
Benjamin Casteigt ◽  
Begoña Benito ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Pulmonary Veins ◽  
Intracardiac Thrombus ◽  
Ablation Procedure ◽  
Recurrent Atrial Fibrillation ◽  
Rule Out

Abstract Background: Pulmonary veins isolation (PVI) is a standard treatment for recurrent atrial fibrillation (AF). Uninterrupted anticoagulation for minimum 3 weeks before the ablation and exclusion of left atrial (LA) thrombus with transesophageal echography (TEE) immediately before or during the procedure minimize peri-procedural risk. We aimed to demonstrate the utility of cardiac tomography (CT) and cardiac magnetic resonance (CMR) to rule out LA thrombus prior to PVI. Methods: Patients undergoing PVI for recurrent AF were retrospectively evaluated. Only patients that started anticoagulation at least 3 weeks prior to the CT/CMR and subsequently uninterrupted until the ablation procedure were selected. An intracardiac echo (ICE) catheter was used in all patients to evaluate LA thrombus. The results of CT/CMR were compared to ICE imaging. Results: We included 272 consecutive patients averaging 54.5 years (71% male; 30% persistent AF). Average CHA2DS2VASC Score was 0.9 and mean LA diameter was 43 mm, 111 patients on Acenocumarol and 161 on direct oral anticoagulants. Anticoagulation was started 227±392 days before the CT/CMR, and 291±416 days before the ablation procedure. CT/CMR diagnosed intracardiac thrombus in 2 cases, both in the LA appendage. A new CT/CMR revealed resolution of thrombus after 6 additional months of uninterrupted anticoagulation. No macroscopic thrombus was observed in any patients with ICE (negative predictive value of 100%; p<0.01).Conclusions: CT and MRI are excellent surrogates to TEE and ICE to rule out intracardiac thrombus in patients adequately anticoagulated prior AF ablation. This is true even for delayed procedures as long as anticoagulation is uninterrupted.

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