scholarly journals An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Mohamed E. Taha ◽  
Ammar Eljack ◽  
Hisham Ibrahim ◽  
Chanwit Roongsritong
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Surgical Removal ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Systemic Embolization ◽  
Clinical Dilemma

The left atrial thrombus is a well-known complication of atrial fibrillation and rheumatic mitral valve disease and carries a high risk for systemic thromboembolism. They are generally dissolved after a certain period of optimal anticoagulation. A large thrombus, on the other hand, may persist even with adequate anticoagulation. The surgical removal of a thrombus theoretically poses some risk of systemic embolization, making its management a clinical dilemma. Furthermore, a refractory thrombus is uncommon. Thus, an evidence-based guideline in selecting the optimal therapy is needed. We report a case of a 74-year-old male with atrial fibrillation and a history of unprovoked pulmonary embolism who was incidentally found to have a massive left atrial thrombus shortly after discontinuing warfarin about 4 months following bioprosthetic aortic valve replacement. The thrombus was refractory to anticoagulation posing a clinical management dilemma. This case is interesting in terms of presentation and the approach to diagnosis and treatment.

Unexpected Left Atrial Thrombus After Aortic Valve Replacement and Left Atrial Ligation With AtriClip Device

2018 ◽  
Vol 10 (2) ◽  
pp. 36-38
Author(s):  
Kinjal M. Patel ◽  
Michael Rosenbloom ◽  
Muhammad Raza ◽  
Sean Stevens ◽  
Jonathan Rost ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus

Left Atrial Volume and Post-Operative Atrial Fibrillation after Aortic Valve Replacement

2010 ◽  
Vol 2 (3) ◽  
Author(s):  
Madhu Reddy Yeruva ◽  
Ruby Satpathy ◽  
Xuedong Shen ◽  
Mark Holmberg ◽  
Claire Hunter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Atrial Volume ◽  
Post Operative Atrial Fibrillation

scholarly journals Transcatheter Aortic Valve Replacement and Left Atrial Appendage Occlusion – A Stitch in Time?

2011 ◽  
Vol 9 (2) ◽  
pp. 126 ◽  
Author(s):  
Sameer Gafoor ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Transcatheter Aortic Valve Replacement ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Transcatheter Aortic Valve

Many patients have now been able to receive transcatheter aortic valve replacement (TAVR) therapy for severe aortic stenosis. These patients have atrial fibrillation and are placed on warfarin for stroke prophylaxis. The opportunity for treatment with left atrial appendage occlusion (LAAO) in place of warfarin for this population exists, especially for those with increased bleeding risk. This paper discusses the prevalence and aetiology of stroke in patients presenting for TAVR (with a focus on the risk from chronic and acute atrial fibrillation) and also the benefit of LAAO closure in this population.

scholarly journals 1623 Atrial Fibrillation Post Aortic Valve Replacement: Prevalence and Causative Factors

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Baker ◽  
A Badran ◽  
M Naseer ◽  
S Ohri
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Ventricular ◽  
Electronic Patient Records ◽  
Left Atrial Diameter ◽  
Echocardiographic Parameters ◽  
The Uk

Abstract Aim Atrial fibrillation (AF) is the most prevalent arrhythmia. Post-Operative AF (POAF) occurs in a third of patients post cardiac surgery. We aim to explore the incidence of AF post aortic valve replacement (AVR) and whether clinical and echocardiographic parameters can predict the likelihood of AF and therefore influence the management of patients. Method Our study consisted of 985 patients who underwent AVR between 2018 – 2019 from a single major cardiothoracic surgery centre in the UK. Data was collected from the electronic patient records retrospectively. Results Mean age of the cohort was 71.8 years (27-92). There were more males (68.2%, n = 672) than females (31.8%, n = 313). A majority of patients (51.8%, n = 510) developed an episode of AF in the post-operative period, of which 65.1% was new onset (n = 330). Incidence of post-operative AF was associated with more HTN (p = 0.007), poor left ventricular function as well as increased left atrial diameter (P = <0.001). Conclusions There is a high incidence of AF following AVR surgery. Comorbidities as well as left atrial diameter have a statistically significant relationship with this incidence and could be used as predictors of postoperative atrial fibrillation.

scholarly journals Postoperative atrial fibrillation after aortic valve replacement is a risk factor for long-term atrial fibrillation

2019 ◽  
Vol 29 (3) ◽  
pp. 378-385 ◽  
Author(s):  
Rasmus Carter-Storch ◽  
Jordi S Dahl ◽  
Nicolaj L Christensen ◽  
Redi Pecini ◽  
Eva V Søndergård ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

AbstractOBJECTIVESPostoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. However, knowledge on the rate of long-term atrial fibrillation (LTAF) after POAF remains unclear. We investigated predictors of POAF in patients with aortic stenosis undergoing surgical aortic valve replacement, and assessed the rate of LTAF during follow-up.METHODSWe prospectively included 96 adult patients with severe aortic stenosis undergoing surgical aortic valve replacement. Patients with previous atrial fibrillation (AF) were excluded. Patients underwent echocardiography, cardiac computed tomography and magnetic resonance imaging immediately prior to surgery. Surgical aortic clamp time and postoperative C-reactive protein (CRP) were documented. POAF was defined as AF recorded within 7 days of surgery. Through chart review, patients were followed up for documented episodes of LTAF occurring more than 7 days after surgery.RESULTSPOAF occurred in 51 patients (53%). It was associated with larger preoperative echocardiographic left atrial volume index (44 ± 12 vs 37 ± 8 ml/m2, P = 0.004), longer aortic clamp time [80 (70–102) vs 72 (62–65) min, P = 0.04] and higher CRP on first postoperative day [80 (64–87) vs 65 (44–83) mg/l, P = 0.001]. Multivariable logistic regression revealed that left atrial volume index [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02–1.13; P = 0.005] and postoperative CRP (OR 1.03, 95% CI 1.01–1.05; P = 0.006) were the only independent predictors of POAF. During 695 days (25th–75th percentile: 498–859 days) of follow-up, LTAF occurred in 11 patients of whom 10 were in the POAF group (hazard ratio 9.4, 95% CI 1.2–74; P = 0.03).CONCLUSIONSPOAF is predicted by left atrial volume index and postoperative CRP. Patients with POAF have a 9-fold increase risk of developing symptomatic LTAF during follow-up.Clinical trial registration numberClinicalTrials.gov (NCT02316587).

Massive Left Atrial Thrombus After a Left Atrial Surgical Ablation and Bioprosthetic Mitral Valve Replacement

2020 ◽  
Vol 15 (4) ◽  
pp. 389-392
Author(s):  
Mustafa Husaini ◽  
Nishath Quader ◽  
Alan C. Braverman ◽  
Ralph J. Damiano ◽  
Hersh S. Maniar
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Patient Centered ◽  
Atrial Thrombus ◽  
Surgical Ablation ◽  
Bioprosthetic Mitral Valve

Variability exists regarding the timing and duration of anticoagulation after surgical ablation for atrial fibrillation and bioprosthetic mitral valve replacement (MVR). We report a case in which a patient developed a massive left atrial (LA) thrombus after MVR and left-sided radiofrequency ablation (LRFA). Despite acutely elevated gradients across the bioprosthetic valve, the patient remained asymptomatic and hemodynamically stable; thus, a multidisciplinary, patient-centered discussion was had and the patient was treated successfully with oral anticoagulation.

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