Fresh Thrombus Formation In Left Atrial Appendage After Temporary Suspension Of Warfarin Treatment In A Patient With Mitral Stenosis And Atrial Fibrillation

摘要

A 61-year-old woman underwent a transoesophageal echocar-diogram (TOE) for further assessment of her rheumatic mitral stenosis 2 days after a right and left heart catheterisation and coronary angiogram. She was receiving warfarin treatment for atrial fibrillation (AF). Her warfarin treatment was temporarily suspended for 5 days before the procedure. The TOE showed severe rheumatic mitral stenosis, moderate mitral regurgitation, a moderately dilated left atrium and left atrial appendage (LAA). The left ventricular size and function were normal. The LAA contained a medium size thrombus amidst spontaneous echo contrast in the left atrium (panel A).