Incidental finding of a left atrial thrombus during surgical management of a massive pulmonary embolism

Sarah Dunn; Nisha Dave; Yiliam Rodriguez-Blanco; Oscar Aljure

doi:10.4103/aca.ACA_119_18

Incidental finding of a left atrial thrombus during surgical management of a massive pulmonary embolism

Sarah Dunn, Nisha Dave, Yiliam Rodriguez-Blanco, Oscar Aljure

Anesthesiology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial thrombus passed across the PFO secondary to increased right heart and pulmonary pressures.

Original language	English (US)
Pages (from-to)	87-89
Number of pages	3
Journal	Annals of Cardiac Anaesthesia
Volume	23
Issue number	1
DOIs	https://doi.org/10.4103/aca.ACA_119_18
State	Published - Jan 1 2020

Keywords

Left atrial thrombus
patent foramen ovale
pulmonary embolism
right ventricular failure
right-to-left shunt

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Anesthesiology and Pain Medicine

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10.4103/aca.ACA_119_18

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abstract = "A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial thrombus passed across the PFO secondary to increased right heart and pulmonary pressures.",

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