Document Detail

Serial changes of left atrial thrombus in mitral stenosis: transesophageal echocardiographic studies in candidates for balloon mitral commissurotomy.
MedLine Citation:
PMID:  8624978     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known concerning therapeutic modification of left atrial thrombus in mitral stenosis and its formation after successful balloon valvuloplasty (percutaneous transvenous mitral commissurotomy [PTMC]). OBJECTIVE: To test the roles of the clinical use of anticoagulant therapy and PTMC, serial changes in left atrial thrombus were examined by transesophageal echocardiography in 80 patients with mitral stenosis. RESULTS: No difference in embolic history, New York Heart Association functional class, cardiac rhythm, left atrial size or mitral valve area was found between patients with (n=23) and without (n=57) left atrial thrombus. Diuretic use was the prevalent factor for left atrial thrombi, which were dissolved completely in seven (30.4%) and partially in eight (34.7%) of the patients by adequate warfarin. However, after PTMC (n=53), newly formed thrombus was observed in four of 51 (7.8%) patients, which correlated with left atrial size (at least 50mm), atrial fibrillation and poorly controlled warfarin (thrombo test: 63.8 +/- 18.8% versus 35.9 +/- 17.7%, P<0.005). The newly formed thrombi were dissolved within several weeks. CONCLUSION: Left atrial thrombus in symptomatic mitral stenosis exhibits elusive characteristics and should be strictly monitored even after successful PTMC by transesophageal echocardiography in order to achieve adequate anticoagulation.
M Hase; K Tsuchihashi; S Yonekura; K Nagao; S Tanaka; K Shimamoto; O Imura
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  12     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-06-25     Completed Date:  1996-06-25     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  278-84     Citation Subset:  IM    
Second Department of Internal Medicine, Sapporo Medical University, School of Medicine, Japan.
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MeSH Terms
Atrial Function, Left
Balloon Dilatation*
Echocardiography, Transesophageal*
Heart Atria / pathology*,  surgery,  ultrasonography
Middle Aged
Mitral Valve Stenosis / complications*,  surgery,  ultrasonography
Thrombosis / complications*,  surgery,  ultrasonography

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