Two-dimensional echocardiography demonstrated a specificity of 98.8% and a sensitivity of 58.8% for detecting left atrial thrombi, missing all 11 thrombi located in the left atrial appendage.
Observational (n=293)
Does two-dimensional echocardiography accurately diagnose left atrial thrombus in patients with rheumatic heart disease undergoing mitral valve surgery?
Two-dimensional echocardiography is highly specific but has limited sensitivity for detecting left atrial thrombi, particularly those located in the left atrial appendage.
Two-dimensional echocardiographic studies were performed in 293 patients with rheumatic heart disease who underwent open-heart mitral valve surgery during an 18-month period. Diagnostic confirmation of a left atrial thrombus was based on direct inspection of the left atrium during surgery and histopathologic examination. Two-dimensional echocardiographic recordings were reviewed. Of the 293 patients, 33 had left atrial thrombi by two-dimensional echocardiographic criteria. This diagnosis was confirmed at surgery and histopathologic study in 30 (specificity 98.8%). A thrombus was not found in three patients. In 21 other patients, left atrial thrombi were present but were not detected by two-dimensional echocardiography (sensitivity 58.8%). Ten of these 21 had thrombi in the left atrial cavity. In 11 patients, thrombi were located in the left atrial appendage, all of which were missed by two-dimensional echocardiography. Excluding these 11 left atrial appendage thrombi, the sensitivity of two-dimensional echocardiography for detecting left atrial cavity thrombi was 75.0%.
Shrestha et al. (Tue,) conducted a observational in Rheumatic heart disease (n=293). Two-dimensional echocardiography vs. Direct inspection during surgery and histopathologic examination was evaluated on Diagnosis of left atrial thrombus. Two-dimensional echocardiography demonstrated a specificity of 98.8% and a sensitivity of 58.8% for detecting left atrial thrombi, missing all 11 thrombi located in the left atrial appendage.