Forgotten, but Not Gone
Journal Title: Heart Research – Open Journal - Year 2015, Vol 2, Issue 2
Abstract
A 65 year old woman, an Asian immigrant to USA, with the history of surgical mitral valvuloplasty through left thoracotomy performed 30 years ago in India for severe rheumatic mitral stenosis, history of embolic occlusion of right femoral artery and surgical embolectomy (3 years ago), chronic atrial fibrillation, presented with dyspnea on exertion. Patient was on Coumadin therapy with therapeutic INR (2-3). Her work up revealed severe mitral stenosis with marked left atrial enlargement. There was massive clot burden in the left atrium. Despite massive left atrial clot, patient had no history of stroke/TIA. She then successfully underwent left atrial thrombectomy with mitral valve replacement. Intra operative findings were very small orifice of mitral valve with fused commissures and chordae tendinae, consistent with severe rheumatic mitral stenosis. Post-operative recovery was uneventful. Patient continues on Coumadin with target INR of 2.5-3.5 with post-operative echocardiograms showing no left atrial clot.
Authors and Affiliations
Srinivasan Sattiraju
Keywords
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- EP ID EP556857
- DOI 10.17140/HROJ-2-115
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