Surgical removal of a free-floating ball thrombus and mitral valve replacement can be successfully performed in patients with chronic mitral stenosis and atrial fibrillation.
Supports surgical feasibility in rare ball thrombus with mitral stenosis; leaves open need for comparative data before practice change.
Left atrial (LA) ball thrombus is a rare disorder. These ball thrombi are generally associated with mitral stenosis, and the restricted mitral orifice encloses the free-floating thrombus in the LA. There is a potential for fatal systemic emboli or mitral valve orifice occlusion that may result in sudden death. We report a rare case of free-floating ball thrombus (FFBT) in the left atrium with mitral stenosis. A 52-year-old woman with chronic mitral stenosis was admitted to the hospital for progressive dyspnea, palpitation and unconsciousness. Electrocardiography showed atrial fibrillation (AF). Echocardiography revealed rheumatic, thickened, and stenotic mitral valve, and FFBT in the left atrium. She was treated successfully with removal of ball thrombus and mitral valve replacement. The size of the ball thrombus was 30×25×15 mm and postoperative course was uneventful.
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Demir et al. (2005) studied this question.
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