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Successful anticoagulation therapy for a giant left atrial thrombus following mitral valve repair.


ABSTRACT: A 72-year-old male with atrial fibrillation (AF) underwent mitral valve (MV) repair and concomitant procedures. He was discharged with therapeutic Warfarin dosing but was readmitted 3 weeks later with a right caudate nucleus infarct and subtherapeutic anticoagulation. Echocardiography showed a giant left atrial (LA) thrombus. Low-molecular-weight heparin was promptly initiated. Unfortunately, the patient suffered an intracranial hemorrhage (ICH) 2 days later. He declined surgical thrombectomy and was managed conservatively, remaining stable without neurological deficits. Serial brain imaging showed interval stability, allowing Warfarin to be resumed. Follow-up echocardiography demonstrated partial and complete resolution of the thrombus at 1 and 3 months, respectively.

SUBMITTER: Mathew EN 

PROVIDER: S-EPMC5542978 | biostudies-other | 2017 Jul

REPOSITORIES: biostudies-other

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