ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Mechanical mitral valve thrombosis and giant left atrial thrombus: Comparison of transesophageal echocardiography and 64-slice multidetector computed tomography [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2009; 37(7): 483-487

Mechanical mitral valve thrombosis and giant left atrial thrombus: Comparison of transesophageal echocardiography and 64-slice multidetector computed tomography

Sabahattin Gündüz1, Mehmet Özkan1, Murat Biteker1, Tahsin Güneysu2
1Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul
2Sonomed Imaging Center, İstanbul

We report on the use of multidetector computed tomography (MDCT) in the diagnosis of prosthetic heart valve thrombosis and a giant left atrial (LA) thrombus extending into the LA appendage (LAA), in comparison with findings of transesophageal echocardiography (TEE). A 52-year-old woman with an eight-year history of mechanical mitral valve (MMV) replacement presented with progressive dyspnea. The electrocardiogram (ECG) showed atrial fibrillation. Transesophageal echocardiography showed severely increased MMV gradients and decreased MMV area. Two thrombi were identified on the atrial aspect of the MMV, one restricting the motion of the lateral leaflet, and the other localized on the septal side of the valve ring. Two other thrombi were also visualized, one in the LA and the other in the LAA, measuring 4.3x1.3 cm and 2.1x1 cm, respectively. ECG-gated 64-slice contrast-enhanced MDCT depicted a thrombus, involving both atrial and ventricular aspects of the MMV, and also a giant thrombus, 8.3x2.4 cm in size, in the LA extending into the LAA. The patient underwent redo-mitral valve replacement, LA thrombectomy, and LAA ligation, and was discharged uneventfully. The size and localization of thrombi in the LA and on the explant MMV matched to the findings of MDCT. In this case, MDCT was superior to TEE in showing the precise nature of both MMV thrombosis and the integrated thrombus involving the LA and LAA.

Keywords: Atrial appendage/radiography, echocardiography, transesophageal, heart atria/radiography; heart valve prosthesis; thrombosis/diagnosis; tomography, X-ray computed.

How to cite this article
Sabahattin Gündüz, Mehmet Özkan, Murat Biteker, Tahsin Güneysu. Mechanical mitral valve thrombosis and giant left atrial thrombus: Comparison of transesophageal echocardiography and 64-slice multidetector computed tomography. Turk Kardiyol Dern Ars. 2009; 37(7): 483-487

Corresponding Author: Sabahattin Gündüz, Türkiye
Manuscript Language: English


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