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Eur J Cardiothorac Surg 2006;30:192
© 2006 Elsevier Science NL

Images in cardio-thoracic surgery

Giant left atrial thrombus in a transplanted heart

Pierre Ambrosi a , Olivier Ghez b , Alberto Ribéri b , Dominique Métras b , *

a Department of Cardiology, Centre Hospitalo-Universitaire de la Timone, Marseille, France
b Department of Cardiothoracic Surgery, Centre Hospitalo-Universitaire de la Timone, 13385 Marseille, Cedex 05, France

Received 13 March 2006; received in revised form 21 March 2006; accepted 22 March 2006.

* Corresponding author. Tel.: +33 491 386676; fax: +33 491 384576. (Email: dominique.metras{at}ap-hm.fr).

Key Words: Heart transplant • Complications • Thrombosis • MRI

Eleven years after heart transplant (HT) with classical atrial anastomosis, the echocardiogram of a 65-year-old asymptomatic patient in sinus rhythm showed a huge left atrial mass, suggestive of thrombus at MRI (Fig. 1 ). Four months earlier the routine echocardiogram was considered normal. Eighteen months after the surgery (Fig. 2 ) and under oral anticoagulants there was no recurrence.


Figure 1
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  		Fig. 1. (A) Long axis view; (B) axial view. Thoracic MRI (T1-weighted sequence) shows a 75 mmx 60 mmx 40 mm thrombus in the large left atrium—RV indicates a right ventricle; LV, left ventricle.

 

Figure 2
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  		Fig. 2. Perioperative view: extracted thrombus.

 
HT with caval anastomosis and almost complete excision of left atrium used since 1992 avoids this complication.




This article has been cited by other articles:


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M. Schnoor, T. Schafer, D. Luhmann, and H. H. Sievers
Bicaval versus standard technique in orthotopic heart transplantation: a systematic review and meta-analysis.
J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1322 - 1331.
[Abstract] [Full Text] [PDF]

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Dominique Métras
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Right arrow Articles by Métras, D.
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