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Incidence and Predictors of Left Atrial Thrombus in Patients with Rheumatic Mitral Stenosis and Sinus Rhythm: A Transesophageal Echocardiographic Study.
MedLine Citation:
PMID:  21426392     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Rheumatic mitral stenosis (MS) predisposes to left atrial (LA) thrombus formation. The reported incidence of LA clot formation in sinus rhythm (SR) is 2.4-13.5% in small studies. Aim: To determine the incidence of LA thrombus in MS in SR in a large cohort of patients and to determine the factors that predict its development. Methods: Total of 848 consecutive patients with MS in SR who were being evaluated for percutaneous transvenous mitral commisurotomy were included in the study. Both transthoracic (TTE) and transesophageal echocardiograms (TEE) were performed to identify clot and other hemodynamic parameters. Results: The mean age of the study population was 34 ± 9 years and the mean mitral orifice area was 0.78 ± 0.18 cm(2) . Out of 848 patients 56 (6.6%) had LA thrombus on TEE. On univariate analysis there was a trend toward thrombus formation in individuals with age >44 years, LA inferosuperior dimension >6.9 cm, mean mitral gradient >18 mmHg and dense spontaneous echo contrast (SEC). On multivariate analysis none of the factors predicted clot formation. Conclusion: The incidence of LA thrombus in MS in SR is 6.6%. TEE is warranted in MS patients in SR when they are >44 years, LA inferosuperior dimension >6.9 cm and mean mitral gradient >18 mmHg. When SEC is absent on TEE, thrombus formation is unlikely. (Echocardiography ****;**:1-4).
Authors:
Cholenahally Nanjappa Manjunath; Kikkeri Hermanna Setty Srinivasa; Arunkumar Panneerselvam; Bhat Prabhavathi; Khandenahally Shankarappa Ravindranath; Kapil Rangan; Chandrasekaran Dhanalakshmi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-23
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  -     ISSN:  1540-8175     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011, Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology Department of Echocardiography, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India.
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