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European Journal of Echocardiography 2006 7(6):418-419; doi:10.1016/j.euje.2005.12.004
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Copyright © 2005, The European Society of Cardiology

Free-floating left atrial thrombus complicating mitral stenosis

Paula Awamleh*, Oscar González and Francisco Luquero

Cardiology Service, Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Getafe, Madrid, Spain

Received 12 August 2005; accepted after revision 4 December 2005.

* Corresponding author. Tel.: +34 91 683 93 60; fax: +34 91 683 98 26. paulaawamleh{at}yahoo.es


   Abstract
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 Abstract
Case report
 
Free-floating thrombus is a rare disorder that usually occurs in the setting of a dilated left atrium. It is an important condition because it can produce sudden death by obstructing the mitral orifice or cause embolic events. Early diagnosis and surgical treatment are mandatory.

Keywords: Mitral stenosis; Free-floating ball thrombus


   Case report
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 Abstract
 Case report
 
A 53-year-old man with moderate mitral stenosis and chronic atrial fibrillation presented with transient ischemic accident. He had good INR levels. Transesophageal echocardiogram showed a giant free-floating, spherical-shaped mass (3x3cm) in the dilated left atrium (Fig. 1). There was abundant spontaneous echocontrast and a low left atrium appendage flow velocity (0.09m/s). The mass had a rhythmic motion with intermittent mitral orifice obstruction. It was surgically removed demonstrating an organized thrombus without wall attachment. The mitral valve was replaced with a mechanical prothesis. His postoperative period was uneventful.


Figure 1
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  		Figure 1 Transesophageal echocardiogram: 5-chamber view showing free-floating left atrial ball thrombus. The movement of the mass caused intermittent obstruction of mitral orifice. Note the thickened and calified mitral valve.

 

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This Article
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