Comparison of left coronary and laevo-phase pulmonary angiograms in detecting left atrial thrombi in rheumatic mitral stenosis

Sharma, SK; Kumar, Mukesh; Reddy, V.M.; Kaul, Upendra; Rajani, M; Venugopal, P

doi:10.1016/s0009-9260(05)80222-3

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…The aforementioned sensitivity and specificity regarding thrombus detection by TOE was found in comparison with intraoperative observations;13) however, no comparison has been made using direct left atrial angiography. Sensitivity for thrombus detection during the left ventricular phase of pulmonary angiogram was found to be 100% compared to later surgical inspection 140). In our own experience with transcatheter LAA occlusion and by means of direct angiography, we detected LAA thrombi not seen with simultaneously performed TOE in approximately 10% of patients (Fig.…”

Section: Cardiac Imaging For Thrombus Detectionmentioning

confidence: 75%

Cardioembolic Stroke in Atrial Fibrillation-Rationale for Preventive Closure of the Left Atrial Appendage

Leithäuser

Park

2009

Korean Circ J

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Atrial fibrillation is the most common cardiac arrhythmias, and a major cause of morbidity and mortality due to cardioembolic stroke. The left atrial appendage is the major site of thrombus formation in non-valvular atrial fibrillation. Loss of atrial systole in atrial fibrillation and increased relative risk of associated stroke point strongly toward a role for stasis of blood in left atrial thrombosis, although thrombus formation is multifactorial, and much more than blood flow irregularities are implicated. Oral anticoagulation with vitamin-K-antagonists is currently the most effective prophylaxis for stroke in atrial fibrillation. Unfortunately, this treatment is often contraindicated, particularly in the elderly, in whom risk of stroke is high. Moreover, given the risk of major bleeding, there is reason to be skeptical of the net benefit when warfarin is used in those patients. This work reviews the pathophysiology of cardioembolic stroke and critically spotlights the current status of preventive anticoagulation therapy. Various techniques to exclude the left atrial appendage from circulation were discussed as a considerable alternative for stroke prophylaxis.

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Section: Cardiac Imaging For Thrombus Detectionmentioning

confidence: 75%

Cardioembolic Stroke in Atrial Fibrillation-Rationale for Preventive Closure of the Left Atrial Appendage

Leithäuser

Park

2009

Korean Circ J

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“…Standen using selective coronary angiography in 1975, described "tumor vascularity" with abnormal vessels arising from the left circumflex artery to the left Page: 34 www.raftpubs.com atrium in a patient with severe mitral stenosis and left atrial thrombus [107]. Coronary neovascularization with fistula formation as a specific sign for the presence of left atrial thrombi has been documented by some investigators [108][109][110][111][112][113][114]. Coronary neovascularization with fistula formation has a sensitivity of 58%, specificity of 98% and positive predictive accuracy of 95% [108][109][110][111][112][113][114][115].…”

Section: Diagnosismentioning

confidence: 99%

“…Coronary neovascularization with fistula formation as a specific sign for the presence of left atrial thrombi has been documented by some investigators [108][109][110][111][112][113][114]. Coronary neovascularization with fistula formation has a sensitivity of 58%, specificity of 98% and positive predictive accuracy of 95% [108][109][110][111][112][113][114][115]. Magnetic resonance imaging may demonstrate the presence of thrombus, but its ability to depict the atrial calcification is suboptimal [116][117][118].…”

Section: Diagnosismentioning

confidence: 99%

A Treatise on the Surgical Management of Porcelain Atrium and Coconut Atrium

Chowdhury

Sankhyan

Gudala

et al. 2019

JCSHD

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The present perspective is a synthesis of 119 published investigations in the setting of porcelain atrium and coconut atrium in the literature. We identified 60 suitable cases (porcelain atrium, n=44; coconut atrium, n=16) from 34 investigations, and reviewed the clinical presentation, diagnostic modalities utilized, surgical techniques employed and outcomes. Roentgenography, cross-sectional transthoracic and transesophageal echocardiography, computerized tomography and fluoroscopy provided the necessary diagnostic information and defined the disease entity before surgery in all patients. Magnetic resonance imaging and selective coronary angiography had been used for further clarification of the presence of intraluminal left atrial thrombus. We then grouped the lesions into two categories, namely “porcelain atrium” and “coconut atrium” that have a bearing on the appropriate surgical approach, discussing appropriate surgical or non-surgical techniques for each group. For the overall group, taking into consideration of the patients subjected to surgical intervention, the operative mortality remains high at 20.6% [porcelain atrium: hospital death 6/30 (20%), coconut atrium: hospital death 1/4 (25%). We submit that an increased appreciation of different types of left atrial wall calcification may well contribute to improved surgical management.

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