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

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...

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Main Authors: Mohamed E. Taha, Ammar Eljack, Hisham Ibrahim, Chanwit Roongsritong
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2019/5254164
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author Mohamed E. Taha
Ammar Eljack
Hisham Ibrahim
Chanwit Roongsritong
author_facet Mohamed E. Taha
Ammar Eljack
Hisham Ibrahim
Chanwit Roongsritong
author_sort Mohamed E. Taha
collection DOAJ
description 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.
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institution Kabale University
issn 2090-6404
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series Case Reports in Cardiology
spelling doaj-art-1574993a61784e7782e92bc7d6932b212025-08-20T03:54:25ZengWileyCase Reports in Cardiology2090-64042090-64122019-01-01201910.1155/2019/52541645254164An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve ReplacementMohamed E. Taha0Ammar Eljack1Hisham Ibrahim2Chanwit Roongsritong3Department of Internal Medicine, University of Nevada, Reno, NV, USADepartment of Internal Medicine, Beaumont Health, Detroit, MI, USADepartment of Internal Medicine, University of Iowa, IA, USADepartment of Heart and Vascular Health, Renown Regional Medical Center, Reno, NV, USAThe 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.http://dx.doi.org/10.1155/2019/5254164
spellingShingle Mohamed E. Taha
Ammar Eljack
Hisham Ibrahim
Chanwit Roongsritong
An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
Case Reports in Cardiology
title An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
title_full An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
title_fullStr An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
title_full_unstemmed An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
title_short An Unusual Case of Left Atrial Mural Thrombus following Aortic Valve Replacement
title_sort unusual case of left atrial mural thrombus following aortic valve replacement
url http://dx.doi.org/10.1155/2019/5254164
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