TT Left Atrial Appendage Thrombus

A left atrial appendage thrombus and left atrial artifacts in a patient with severe mitral stenosis

June 19, 2022
Pages 1 -3

A 50-year-old female patient (BSA= 1.6 m2) with severe rheumatic mitral valve stenosis (area at planimetry= 1.4 cm2; mean gradient= 7 mmHg; PHT area= 1.4 cm2), chronic atrial fibrillation and severe LV systolic dysfunction (Ejection fraction= 37 %) was admitted for mitral valve replacement surgery.
LV end-diastolic volume= 53 ml/m2 with diffuse hypokinesis; normal wall thickness; increased estimated left atrial pressure (pulmonary regurgitation end-diastolic gradient= 12 mmHg); normal estimated pulmonary systolic pressure (32 mmHg). Normal right ventricular systolic function; mild tricuspid regurgitation.
The left atrium was severely dilated (end-systolic volume= 86 ml/m2) with evidence of 2 thrombi inside the left atrial appendage and on the lateral atrial wall (Figure 1).

Figure 1. 2D paratsernal short axis, left atrium and appendage
Figure 1. 2D paratsernal short axis, left atrium and appendage