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February 21, 2020BMC Cardiovascular DisordersOpen Access

Reccurent thrombus in the gigantic left atrium during effective anticoagulant therapy: case report

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Key result

A combination of rivaroxaban and clopidogrel resulted in partial regression of a recurrent sessile thrombus on the posterior wall of a gigantic left atrium after mitral valve surgery.

Why the study?

Does a combination of rivaroxaban and clopidogrel improve thrombus regression in a patient with a gigantic left atrium and recurrent thrombus despite effective vitamin K antagonist therapy?

Population

A 73-year-old male with recurrent sessile thrombus in a gigantic left atrium

Design

Case report

Authors

LMLucia MasárováJNJan NovákMPMartin Pešl

Discussion

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Overview

May offer an alternative for recurrent LA thrombus after VKA failure in giant LA; hypothesis-generating and requires prospective validation.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does a combination of rivaroxaban and clopidogrel improve thrombus regression in a patient with a gigantic left atrium and recurrent thrombus despite effective vitamin K antagonist therapy?

P
Population
1 patient (n=1), 73-year-old male with a gigantic left atrium, permanent atrial fibrillation, and non-rheumatic mitral regurgitation post mitral valve replacement with a bioprosthesis.
I
Intervention
Combination of rivaroxaban and clopidogrel
O
Outcome
Thrombus regression measured by echocardiography and cardiac magnetic resonancesurrogate

Off-label use of rivaroxaban combined with clopidogrel successfully reduced a recurrent left atrial thrombus in a patient with a gigantic left atrium and biological mitral valve after VKA failure.

Limitations

  • Single case report
  • Off-label use of NOACs in a patient with a biological heart valve

Cite This Study

Masárová et al. (2020) conducted a case report in Recurrent left atrial thrombus with gigantic left atrium and atrial fibrillation (n=1). Rivaroxaban and clopidogrel vs. Vitamin K antagonists (previous therapy) was evaluated on Thrombus size reduction. A combination of rivaroxaban and clopidogrel resulted in partial regression of a recurrent sessile thrombus on the posterior wall of a gigantic left atrium after mitral valve surgery.

synapsesocial.com/papers/6a1c690a66d062ff2dc3c738https://doi.org/10.1186/s12872-019-01279-1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Gigantic Thrombus of the Left Atrium in Mitral Stenosis2017 · 6 citations
  2. 2Large Left Atrial Thrombus in a Patient With Severe Mitral Stenosis and Atrial Fibrillation Despite Anticoagulant Therapy: A Case Report2024
  3. 3A RARE CASE OF “YO-YO”-LIKE LEFT ATRIAL APPENDAGE THROMBUS CAUSING FUNCTIONAL MITRAL STENOSIS.2007
  4. 4Complications of a Giant Left Atrium - Extensive Thrombus Formation Despite Therapeutic Anticoagulation2023
  5. 5Early Massive Left Atrial Thrombosis Following Mitral Bioprosthetic Valve Replacement Due to Suboptimal Anticoagulation: A Case Report2025