Right Atrium Clot Formation following Percutaneous Transmitral Valvuloplasty

This case report describes a rare complication of percutaneous transmitral commissurotomy (PTMC). A patient with severe mitral stenosis developed a clot in the right atrium after an unsuccessful PTMC procedure. Because of the high risk of thromboembolism, the patient underwent urgent surgery to remove the clot and to replace the mitral valve with a mechanical prosthesis.

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Percutaneous Balloon Mitral Valvuloplasty and Early Right Atrial Clot Formation: A Case Report

The Journal of Tehran University Heart Center ◽

10.18502/jthc.v15i2.4188 ◽

2020 ◽

Author(s):

Rezvaniyeh Salehi ◽

Naser Aslan Abadi ◽

Razieh Parizad ◽

Sanam Mirzayi ◽

Elnaz Javanshir

Keyword(s):

Case Report ◽

Right Atrium ◽

Mitral Stenosis ◽

Clot Formation ◽

Right Atrial ◽

Exertional Dyspnea ◽

Mitral Valvuloplasty ◽

Percutaneous Balloon Mitral Valvuloplasty ◽

Percutaneous Balloon ◽

The Right

Percutaneous balloon mitral valvuloplasty (PBMV) has recently become the treatment of choice for many patients suffering from mitral stenosis. In the current report, we introduce a 26-year-old woman who presented to us with palpitation and exertional dyspnea but without any remarkable medical history. ECG illustrated the sinus rhythm, transthoracic echocardiography (TTE) showed severe rheumatic mitral stenosis and (2+) mitral regurgitation, and transesophageal echocardiography (TEE) demonstrated severe mitral stenosis and no thrombus. Accordingly, the patient underwent percutaneous transvenous mitral commissurotomy (PTMC). On the following day, TTE showed a fresh mobile thrombus in the right atrium attached to the atrial septum, which was confirmed by TEE. As a result, the patient received 1 mg/kg (60 mg) of enoxaparin subcutaneously twice daily plus 5 mg of warfarin daily. Subsequent TTE revealed no mass 4 days after the treatment. Evidence suggests that endocardial surface injury and trans-septal puncture during PTMC may be associated with clot formation, which is aggravated by low blood flow in the right atrium and the catheter as a foreign body. This case report emphasizes the importance of postPTMC anticoagulant therapy.

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Right Coronary Artery Fistula Draining into the Right Atrium and Associated with Mitral Valve Stenosis: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf98.20071002 ◽

2007 ◽

Vol 10 (4) ◽

pp. E325-E328 ◽

Cited By ~ 2

Author(s):

Ali Gürbüz ◽

Ufuk Yetkin ◽

Ömer Tetik ◽

Mert Kestelli ◽

Murat Yesil

Keyword(s):

Case Report ◽

Coronary Artery ◽

Mitral Valve ◽

Right Coronary Artery ◽

Right Atrium ◽

Coronary Artery Fistula ◽

Mitral Valve Stenosis ◽

The Right

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Mitral Re-Repair and Right Coronary Fistula Closure Advantage of Minimally Invasive Approach

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/155698451000500614 ◽

2010 ◽

Vol 5 (6) ◽

pp. 456-459 ◽

Cited By ~ 1

Author(s):

Vincenzo Giordano ◽

Jan G. Grandjean

Keyword(s):

Mitral Valve ◽

Right Atrium ◽

Mild Hypothermia ◽

Posterior Wall ◽

Coronary Arteriography ◽

Coronary Fistula ◽

Invasive Approach ◽

Concomitant Procedure ◽

Echocardiographic Images ◽

The Right

A 51-year-old man developed severe mitral regurgitation 10 years after previous mitral valve repair; the echocardiographic images showed a remarkable eccentric jet toward posterior wall of left atrium associated with a high degree of pulmonary vein retrograde flow. The coronary arteriography pointed out no pathologic lesions but a coronary fistula from the proximal right coronary to the right atrium. The standard approach was avoided, and a right anterolateral minithoracotomy was chosen, providing an excellent view. Under cardiopulmonary bypass and mild hypothermia, the mitral valve was re-repaired, and a new ring was implanted. After aortic cross-clamp release, the right coronary fistula was closed through the right atrium. The postoperative course was uneventful, and the patient was discharged on the fourth postoperative day. In such a high-risk reintervention and concomitant procedure, we think that this different approach may represent a feasible and reliable alternative.

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P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.362 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

S Akhunova ◽

R Khayrullin ◽

N Stekolshchikova ◽

M Samigullin ◽

V Padiryakov

Keyword(s):

Pulmonary Artery ◽

Right Ventricle ◽

Right Atrium ◽

Percutaneous Vertebroplasty ◽

Rare Complication ◽

Clinical Manifestations ◽

Stable Condition ◽

Right Atrial ◽

Cement Embolism ◽

The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

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Intraocular Lens Dislocation after Cataract Surgery in Tambolaka, Southwest Sumba, Indonesia: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000487228 ◽

2018 ◽

Vol 9 (1) ◽

pp. 179-184

Author(s):

Ratna Sitompul

Keyword(s):

Case Report ◽

Intraocular Lens ◽

Rural Areas ◽

Rare Complication ◽

Cataract Extraction ◽

Factors Affecting ◽

Intraocular Lens Dislocation ◽

Post Surgery ◽

The Right ◽

Iol Dislocation

Intraocular lens (IOL) dislocation is a rare complication of cataract extraction requiring prompt surgery. This case report aims to raise awareness of such cases and the importance of post-surgery follow-up. A 58-year-old female patient was found with anterior IOL dislocation a week after phacoemulsification surgery in her right eye. Visual acuity of the right eye was 1/60 with ciliary injection and IOL dislocation to the anterior chamber of the right eye. The patient underwent surgery of the right eye and the IOL haptic was found to be broken. In this case report, the factors affecting IOL dislocation are axis length, broken IOL haptic, and patient activity that increased intraocular pressure. Cataract extraction surgery, although common, needs to be conducted carefully, and it is important for ophthalmologists and general practitioners to detect this condition, especially in rural areas where facilities are limited, as IOL dislocation could occur and requires immediate treatment to achieve a better result.

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