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

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.

Left atrial thrombus in isolated aortic valve disease in sinus rhythm

2007 ◽  
Vol 23 (4) ◽  
pp. 289-289
Author(s):  
Hetan Shah ◽  
Basavanthappa Shriniwas ◽  
Ajay Mahajan ◽  
Jagdish Khandeparkar
Keyword(s):  
Aortic Valve ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus

scholarly journals Safe Technique of Removal of Left Atrial Thrombus during Mitral Valve Replacement Surgery

2016 ◽  
Vol 31 (1) ◽  
pp. 26-28
Author(s):  
Rampada Sarker ◽  
Manoz Kumar Sarker ◽  
AM Asif Rahim ◽  
Abdul Khaleque Beg
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Safe Procedure ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Ventricular Cavity

Background: Open mitral operation in patients with massive left atrial thrombus still with high mortality due to intra-operative embolism. To prevent this mortality due to intra-operative embolism and to prevent this danger we practiced a surgical technique which includes careful handling of heart and obliteration of left ventricular cavity by bilateral compression.Method: We used this technique in patients of severe mitral stenosis with atrial thrombus during mitral valve replacement. Our technique was to obliterate the left ventricular cavity and thus keep the mitral cusps in a coapted position by placing gauge posterior to left ventricle and a compression over right ventricle by hand of an assistant with a piece of gauze. This obliteration prevented passage of fragments of left atrial thrombus towards collapsed left ventricle.Result: Before practicing this technique, 4 out 9 patients expired due to cerebral embolism . But after implementation of this technique in 17 patients no mortality or morbidity occurred.Conclusion: This technique of removal of left atrial thrombus during mitral valve replacement may be a safe procedure for preventing peroperative embolism.Bangladesh Heart Journal 2016; 31(1) : 26-28

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 P1518 Relationship between post-operative asymptomatic status and reverse remodeling of large left atrium in patients with aortic stenosis who underwent aortic valve replacement

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Hozumi ◽  
J Morimoto ◽  
T Nishi ◽  
K Takemoto ◽  
S Fujita ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Reverse Remodeling ◽  
Atrial Volume

Abstract Introduction Recently, we have reported that large left atrial volume (minimum left atrial volume index : LAVImin ≥30ml/m²) at end-diastole determined by direct exposure of left ventricular (LV) end-diastolic pressure can predict post-operative symptomatic status after aortic valve replacement (AVR) in aortic stenosis (AS) patients with high sensitivity and modest specificity. Reverse remodeling of large LAVImin after AVR may contribute to false positive for the prediction of post-operative symptomatic status in patients with AS. Purpose The purpose of this study was to evaluate relationship between post-operative symptomatic status and reverse remodeling of large LAVImin in patients with AS who underwent AVR. Methods The study population consisted of 75 patients with AS who underwent AVR and were followed up for 600 days after AVR, after the exclusion of the followings; atrial fibrillation, significant coronary artery disease, significant mitral valve disease, pacemaker rhythm, and inadequate echocardiographic images. We measured LAVImin by biplane Simpson"s method before and after AVR. Preoperative large LAVImin (≥30ml/m²) according to the previous study was observed in 32 (43%) of 75 patients. We divided these 32 patients into two groups according to the post-operative symptomatic status during the follow-up period. Results There was no significant difference in pre-operative LAVImin between patients with and without post-operative symptom (46.5 ± 13.4 vs 40.4 ± 8.6 ml/m²). On the other hand, post-operative LAVImin in patients without post-operative symptom was significantly smaller than that in patients with post-operative symptom (31.5 ± 8.6 vs 54.8 ± 14.0 ml/m², p < 0.01). While significant regression in LAVImin after AVR was observed in patients without post-operative symptom (40.4 ± 8.6 to 31.5 ± 8.6 ml/m², p < 0.05), no regression in LAVImin after AVR was observed in patients with post-operative symptom (46.5 ± 13.4 to 54.8 ± 14.0 ml/m²). Conclusions Reverse remodeling of large LAVmin in patients with AS who underwent AVR was observed in post-operative asymptomatic group, but not in symptomatic group. These results suggest that reverse remodeling of large LAVImin after AVR could contribute to the post-operative asymptomatic status in patients with AS who underwent AVR.

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