Sage Journals: Discover world-class research

Abstract

Variability exists regarding the timing and duration of anticoagulation after surgical ablation for atrial fibrillation and bioprosthetic mitral valve replacement (MVR). We report a case in which a patient developed a massive left atrial (LA) thrombus after MVR and left-sided radiofrequency ablation (LRFA). Despite acutely elevated gradients across the bioprosthetic valve, the patient remained asymptomatic and hemodynamically stable; thus, a multidisciplinary, patient-centered discussion was had and the patient was treated successfully with oral anticoagulation.

Keywords

thrombus thrombolytics anticoagulation

Get full access to this article

View all access options for this article.

References

Nishimura

RA.

Otto

CM.

Bonow

et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135: e1159–e1195.doi:10.1161/CIR.0000000000000503

http://www.ncbi.nlm.nih.gov/pubmed/28298458

Nishimura

RA.

Otto

CM.

Bonow

et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2014; 63: e57–e185.doi:10.1016/j.jacc.2014.02.536

http://www.ncbi.nlm.nih.gov/pubmed/24603191

Badhwar

Rankin

JS.

Damiano

et al. The Society of Thoracic Surgeons 2017 clinical practice guidelines for the surgical treatment of atrial fibrillation. Ann Thorac Surg 2017; 103: 329–341.doi:10.1016/j.athoracsur.2016.10.076

http://www.ncbi.nlm.nih.gov/pubmed/28007240

Calkins

Hindricks

Cappato

et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 2017; 14: e275–e444.doi:10.1016/j.hrthm.2017.05.012

http://www.ncbi.nlm.nih.gov/pubmed/28506916

Schwann

TA.

Habib

RH.

Suri

et al. Variation in warfarin use at hospital discharge after isolated bioprosthetic mitral valve replacement: an analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Chest 2016; 150: 597–605.doi:10.1016/j.chest.2016.04.015

http://www.ncbi.nlm.nih.gov/pubmed/27132702

Chung

Sami

Albert

et al. Variations in anticoagulation practices following the maze procedure. J Atr Fibrillation 2015; 8: 1273.doi:10.4022/jafib.1273

http://www.ncbi.nlm.nih.gov/pubmed/27957208

Henry

Shuman

et al. A more specific anticoagulation regimen is required for patients after the cox-maze procedure. Ann Thorac Surg 2014; 98: 1331–1338.doi:10.1016/j.athoracsur.2014.05.088

http://www.ncbi.nlm.nih.gov/pubmed/25152383

Egbe

AC.

Connolly

HM.

Pellikka

et al. Outcomes of warfarin therapy for bioprosthetic valve thrombosis of surgically implanted valves: a prospective study. JACC Cardiovasc Interv 2017; 10: 379–387.doi:10.1016/j.jcin.2016.11.027

http://www.ncbi.nlm.nih.gov/pubmed/28231905

Pet

Robertson

JO.

Bailey

et al. The impact of CHADS₂ score on late stroke after the Cox maze procedure. J Thorac Cardiovasc Surg 2013; 146: 85–89.doi:10.1016/j.jtcvs.2012.03.087

http://www.ncbi.nlm.nih.gov/pubmed/22818126

10.

Buber

Luria

Sternik

et al. Left atrial contractile function following a successful modified Maze procedure at surgery and the risk for subsequent thromboembolic stroke. J Am Coll Cardiol 2011; 58: 1614–1621.doi:10.1016/j.jacc.2011.05.051

http://www.ncbi.nlm.nih.gov/pubmed/21958889

11.

Aoyagi

Tayama

Fukunaga

et al. Left atrial thrombosis following mitral valve repair and maze procedure: case report. J Heart Valve Dis 2003; 12: 714–716.http://www.ncbi.nlm.nih.gov/pubmed/14658811

12.

Weimar

Schena

Bailey

et al. The cox-maze procedure for lone atrial fibrillation: a single-center experience over 2 decades. Circ Arrhythm Electrophysiol 2012; 5: 8–14.doi:10.1161/CIRCEP.111.963819

http://www.ncbi.nlm.nih.gov/pubmed/22095640

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

3.31 MB

0.00 MB

Massive Left Atrial Thrombus After a Left Atrial Surgical Ablation and Bioprosthetic Mitral Valve Replacement

Abstract

Keywords

Get full access to this article

References

Supplementary Material