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Clinical Medical
Image Library
ISSN: 2474-3682
IMAGE ARTICLE | VOLUME 1, ISSUE 2 | OPEN ACCESS DOI: 10.23937/2474-3682/1510018

Giant Floating Right Atrial Thrombus Following Balloon Mitral Valvuloplasty

Georgina Fuertes Ferre1 , Maria Carmen Aured Guallar2, Esther Sánchez Insa1 and Jose Gabriel Galache Osuna1

1Interventional Cardiology Unit, Miguel Servet University Hospital, Zaragoza, Spain

2Echocardiography Department, Miguel Servet University Hospital, Zaragoza, Spain

*Corresponding author: Georgina Fuertes Ferre, Paseo de Isabel La Catolica, 1-3, 50009, Zaragoza, Spain, Tel: +34 976765500, Fax: +34 976562565, E-mail: georginaff@hotmail.com

Published: December 06, 2015

Citation: Fuertes-Ferre G, Guallar MCA, Insa ES, Osuna JGG (2015) Giant Floating Right Atrial Thrombus Following Balloon Mitral Valvuloplasty. Clin Med Img Lib 1:018. doi.org/10.23937/2474-3682/1510018

Copyright: © 2015 Fuertes-Ferre G, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords


Thrombus, Balloon mitral valvuloplasty

Case Report


A 83 years-old woman underwent percutaneous balloon mitral valvuloplasty (PBMV) due to symptomatic rheumatic mitral stenosis. The transesophageal echocardiogram before PBMV revealed no atrial thrombus. PMBV was performed under fluoroscopic guidance. Following PBMV, an obstruction of the catheter lumen was detected. The transthoracic echocardiogram (TTE) showed a giant mass in the right atrium (Figure 1A), free mobile and eventually prolapsing into the right ventricle (Video). The large thrombus was completely removed percutaneously (Figure 1B), confirmed by TTE (Figure 1C). Despite the use of unfractionated heparin, thrombus formation during PBMV can occur. Echocardiographic imaging is crucial for the detection of thrombus, which cannot be identified by fluoroscopy.

Disclosure


There are no potential conflicts of interest to declare.

Role of the funding source


No funding was received related to this manuscript.

 

Figure 1: A) Transthoracic Echocardiography (TTE) showing the large mass/thrombus floating in the right atrium (arrow);
B) Fresh thrombus removed using transcatheter aspiration technique.
C) TTE showing no evidence of residual thrombus in the right atrium. RA: Right atrium, LA: left atrium, RV: right ventricle.

Video: Transthoracic echocardiography imaging of the free right atrial thrombus highly mobile, eventually prolapsing into the right ventricle.