Echocardiographic Detection and Treatment of Right Intracavitary Thrombosis - A Review of 56 Cases

Abstract

Echocardiographie detection of right intracavitary thrombosis has been frequently described in recent years. Little is known of the natural history of this condition making therapeutic interventions difficult to assess. The case reports of 56 patients (including 5 from our institution) were reviewed. Thrombus was frequently located in the right atrium, the majority of which were highly mobile. The latter often occurred in association with deep venous thrombosis and pulmonary emboli. Almost 30% of mobile thrombus spontaneously embolized soon after detection. Nonmobile thrombus, by contrast, occurred in the setting of impaired contraction of the right heart chambers and was relatively stable. Surgical removal of mobile thrombus was associated with a lower mortality than patients treated medically. Prospective échocardiographie evaluation of patients at increased risk for right intracavitary thrombus is necessary for more definitive evaluation of the incidence, natural history and results of therapeutic intervention.