Trans-oesophageal Echocardiographic Appraisal of Left Atrial Appendage Clot in Severe Mitral Stenosis
Journal Title: Nepalese Heart Journal - Year 2013, Vol 10, Issue 1
Abstract
Background and Aims Left atrial appendage clot is a common complication of mitral stenosis. The management of patient differs signifcantly if there is presence of clot. Various factors had been studied as a risk factor for clot formation. We aim to assess the prevalence of left atrial appendage clot by trans-oesophageal echocardiography in patients of severe mitral stenosis planned for percutaneous transvenous mitral commissurotomy and analyze the factors responsible for it. Methods: An oservational prevalence study was conducted among 100 patients of severe mitral stenosis who were undergoing transoesophageal echocardiography before percutaneous transvenous mitral commissurotomy and prevalence of left atrial appendage clot were recorded. Data were entered in the SPSS and factors responsible for clot formation were analyzed. Results: Out of 100 enrolled patients, 69 (69%) were female. Mean age of presentation was 37.4±13.70 years. Mean age of female was 38.11±13.13 years and male was 35.80±14.98 years. Mean mitral valve area was 0.87±0.12 cm2 and mean left atrial size was 4.79±0.60 cm. Atrial Fibrillation was present in 32 (32%) patients. Transoesophageal echocardiography revealed left atrial appendage clot in 28 (28%). Gender showed no correlation with presence of clot (p=0.06). Increasing age (p=0.002), presence of Atrial Fibrillation (p=0.005) and larger left atrial size (p<0.01) showed signifcant positive correlation with left atrial appendage clot formation. Conclusion: Left atrial appendage clot was common fnding in severe mitral stenosis patients. Patients with advanced age, presence of atrial fbrillation and larger left atrial size were more likely to have clot formation.
Authors and Affiliations
Rabindra Simkhada| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu Nepal, Man Bahadur KC| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Yadav Deo Bhatt| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Arun Maskey| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Rabi Malla| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Deewakar Sharma| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Rajeeb Rajbhandari| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Yuba raj Limbu| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Subodh Kansakar| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Sajan Gopal Baidhya| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Ranjit Sharma| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Himanshu Prasad Nepal| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Binay Kumar Rauniyar| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Dharma Nath Yadav| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Dipanker Prajapati| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Rabindra Pandey| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Nagma Shrestha| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal, Satish Kumar Singh| Department of cardiology,Shahid Gangalal National Heart centre, Kathmandu,Nepal
Keywords
Related Articles
- EP ID EP15727
- DOI http://dx.doi.org/10.3126/njh.v10i1.9744
- Views 316
- Downloads 18
Allergic reacton to long – term Benzathine penicillin injecton for secondary preventon of acute rheumatc fever and recommendatons for skin testng
Background Rheumatc Fever (RF) causes 25-40% of all cardio vascular disease in developing countries. Long term benzathine penicillin injecton is being used for secondary prophylaxis of RF / RHD. Although allergic react...
Trans-oesophageal Echocardiographic Appraisal of Left Atrial Appendage Clot in Severe Mitral Stenosis
Background and Aims Left atrial appendage clot is a common complication of mitral stenosis. The management of patient differs signifcantly if there is presence of clot. Various factors had been studied as a risk facto...
Fetal Echocardiography:Short Term Profle from Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Background and Aims: Fetal echocardiography is helpful in early detection of Congenital Heart Disease.Our study was conducted to evaluate the most common indications of referral and outcome in a tertiary-care fetal ech...
Percutaneous Transluminal Mitral Commisuriotomy for Mitral Stenosis in Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Mitral stenosis (MS) is almost invariably the result of long term complication of rheumatic fever. Based upon the nature and severity of MS, patients can be managed with medical treatment, percutaneous transvenous mitr...
Development of Non-Invasive Cardiology in Nepal