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


Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL, USA

Correspondence Address:
Sarah Dunn
7728 Abbott Ave. Unit 301, Miami Beach, FL 33141
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_119_18

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Year : 2020  |  Volume : 23  |  Issue : 1  |  Page : 87-89

 

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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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Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL, USA

Correspondence Address:
Sarah Dunn
7728 Abbott Ave. Unit 301, Miami Beach, FL 33141
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_119_18

Rights and Permissions

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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