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

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

Research output: Contribution to journalArticlepeer-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 languageEnglish (US)
Pages (from-to)87-89
Number of pages3
JournalAnnals of Cardiac Anaesthesia
Volume23
Issue number1
DOIs
StatePublished - 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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