Accidental left atrial appendage thrombus detected by intraoperative transesophageal echocardiography during coronary artery bypass graft: A case report.
10.17085/apm.2016.11.4.389
- Author:
Joo Hyun JUN
1
;
Mi Hyeon LEE
;
Eun Mi CHOI
;
Eun mi KIM
;
Hyo Keun LEE
;
Seyng Hwa BAEK
;
Mi Hwa CHUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. mhchung20@hanmail.net
- Publication Type:Case Report
- Keywords:
Atrial appendage;
Thrombosis;
Transesophageal echocardiography
- MeSH:
Aged;
Atrial Appendage*;
Cardiopulmonary Bypass;
Coronary Artery Bypass*;
Coronary Vessels*;
Echocardiography;
Echocardiography, Transesophageal*;
Female;
Heart Atria;
Heart Ventricles;
Humans;
Hypokinesia;
Intensive Care Units;
Patients' Rooms;
Postoperative Care;
Sutures;
Thrombosis*;
Transplants;
Tricuspid Valve Insufficiency
- From:Anesthesia and Pain Medicine
2016;11(4):389-392
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 77-year-old woman was scheduled for a coronary artery bypass graft. Her preoperative transthoracic echocardiographic (TTE) examination revealed an enlarged left atrium with reduced systolic dysfunction (ejection fraction: 38%), moderate global hypokinesia of the left ventricle, and moderate mitral and tricuspid regurgitation. No thrombus was visualized on the preoperative TTE. However, the intraoperative transesophageal echocardiography performed before the cardiopulmonary bypass revealed a thrombus of approximately 1.3 × 1.8 cm in the left atrial appendage (LAA). The LAA thrombus was removed, an internal suture was placed on the LAA before the coronary artery bypass grafting, and the main operation was performed successfully. The patient was transferred to the intensive care unit to receive postoperative care. She was extubated 4 h after the surgery and was transferred to the general ward on postoperative day 3 without any neurological sequelae.
