Protruding thrombus in the left atrium found 7 years after percutaneous transvenous mitral commissurotomy: report of a case

Surg Today. 2003;33(1):55-7. doi: 10.1007/s005950300010.

Abstract

A 50-year-old man was transferred to our hospital for investigation of cerebellar infarction, thought to have been caused by cardiac thromboembolism. We assumed that the cardiac thromboembolism had occurred as a late complication of a percutaneous transvenous mitral commissurotomy (PTMC) performed 7 years earlier. An echocardiogram and thoracic computed tomography revealed a protruding thrombus in the left atrium and an emergency operation was performed. The protruding thrombus was found to originate from the scar that penetrated into the intra-atrial muscular septum caused by the PTMC. After removing the thrombus, the scar was covered with normal endothelium and the mitral valve was replaced with a 27-mm St. Jude Medical prosthetic valve. We think that the thromboembolism was caused by mitral valve restenosis, atrial fibrillation, and endothelial injury in the interatrial septum during PTMC. Therefore, long-term follow-up and appropriate medication is recommended after PTMC, since restenosis and thrombosis are likely to occur.

Publication types

  • Case Reports

MeSH terms

  • Cerebral Infarction / etiology
  • Echocardiography
  • Heart Atria / pathology*
  • Heart Diseases / etiology*
  • Heart Diseases / pathology
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / surgery*
  • Postoperative Complications*
  • Thromboembolism / complications
  • Thromboembolism / etiology
  • Thrombosis / etiology*
  • Thrombosis / pathology
  • Time Factors