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Eur J Cardiothorac Surg 2005;28:164
© 2005 Elsevier Science NL

Images in cardio-thoracic surgery

Giant free floating left atrial thrombus

Axel Bauer * , Christian von Bary, Julia Dorn, Karl Dennig

Abteilung fuür Kardiologie, Deutsches Herzzentrum Muünchen, Lazarettstr. 36, 80636 Muünchen, Germany

Received 11 February 2005; received in revised form 24 March 2005; accepted 29 March 2005.

* Corresponding author. Tel.: +49 89 1218 4045; fax: +49 89 1218 4006. (Email: bauer.de{at}web.de).

Key Words: Thrombus • Atrial fibrillation • Left atrium

A 74-year-old woman with dilative cardiomyopathy and chronic atrial fibrillation presented with symptoms of progressive heart failure. Transthoracic echocardiography showed a giant free floating mass in the dilated left atrium (Fig. 1 A and B). The mass was surgically removed demonstrating an organized thrombus without wall attachment (Fig. 2 ). The postoperative course was uneventful under optimised anticoagulation.



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  		Fig. 1. Transthoracic echocardiography at admission showing a large free floating mass in the left atrium which is occassionally located at the dorsal wall (A) but approaches also the orifice of the mitral valve (B).

 


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  		Fig. 2. Macroscopic view of the thrombus after surgical extraction measuring 4cm in diameter and showing a polished surface resembling that of a ping-pong ball.

 
Appendix

Supplementary data

Appendix

Supplementary data

Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.ejcts.2005.03.040





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