Surgical removal under cardiopulmonary bypass followed by warfarin therapy is an effective management strategy for right atrial pedunculated ball thrombus.
Supports surgical thrombectomy plus warfarin for right atrial ball thrombus; case reports leave optimal strategy open.
Two rare cases of right atrial pedunculated ball thrombus associated with constrictive pericarditis and systemic lupus erythematosus are reported. Under cardiopulmonary bypass, the large thrombus in each patient was removed with care to avoid pulmonary embolism. Both patients have been doing well postoperatively and warfarin has been administered to prevent a recurrence of intracardiac thrombotic episodes.
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Inoue et al. (1999) studied this question.
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