Key result
Emergency surgery with left femoro-femoral cardiopulmonary bypass successfully treated a left atrial ball valve thrombus, leading to an uneventful recovery.
Case Report (n=1)
A left atrial ball valve thrombus can cause posture-related syncope in patients with mitral stenosis and may require emergency surgical intervention.
May support emergency femoro-femoral bypass for left atrial ball valve thrombus; leaves open optimal strategies pending larger studies.
A 74 year old woman with mixed mitral valve disease presented with episodes of loss of consciousness and fainting. The attacks were noted to be closely related to posture, especially crouching, and this, with the clinical finding that the radial pulse disappeared before she lost consciousness, suggested the diagnosis of a ball valve thrombus. Cardiac catheterisation confirmed the diagnosis but was followed by a fall in blood pressure necessitating emergency surgery. The only position in which the circulation could be maintained was the right lateral, with steep head down tilt, and left femoro-femoral cardiopulmonary bypass had to be established in this position. Operation confirmed the presence of a ball valve thrombus and the patient recovered uneventfully.
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Dent et al. (1983) conducted a case report in Left atrial ball valve thrombus and mixed mitral valve disease (n=1). Emergency surgery with left femoro-femoral cardiopulmonary bypass was evaluated on Patient recovery. Emergency surgery with left femoro-femoral cardiopulmonary bypass successfully treated a left atrial ball valve thrombus, leading to an uneventful recovery.
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