FREQUENCY OF LEFT ATRIAL THROMBUS IN PATIENTS OF MITRAL STENOSIS SUITABLE FOR PERCUTANEOUS TRANS-SEPTAL MITRAL COMMISSUROTOMY

Abstract

Objective: To determine frequency of left atrial thrombus in patients of mitralstenosis suitable for percutaneous trans-septal mitral commissurotomy.

Methodology: It was a Descriptive cross sectional study conducted in theOutpatient Department of Chaudary Pervaiz Elahi Institute of Cardiology, Multanfrom April 2012 to October 2012. Ninty Five patients of tight mitral stenosis2 (Mitral valve area ≤ 1cm and mean transvalvular gradient > 10 mm Hg) havingsinus rhythm suitable for PTMC (as assessed on trans-thoracicechocardiography) were included in the study. Trans esophagealechocardiography was performed for the presence or absence of left atrialthrombus .

Results: Out of 95 patients, male were 37.9% while female were 62.1%. Meanage of the patients was 26.88 ± 6.76 years. Left atrial thrombus was identified in8(8.4%) patients. In age ≤ 25 years, there were 42 patients and 4(9.5%) werediagnosed to have left atrial thrombus while in age > 25 years, there were 53patients and 4(7.5%) patients had left atrial thrombus on trans-esophagealechocardiography. Among 59 females, left atrial thrombus was diagnosed in5(8.4%), while in 36 males, left atrial thrombus was diagnosed in 3(8.3%)patients.

Conclusion: Left atrial thrombus occurs in a significant proportion of patientswith mitral stenosis and a normal sinus rhythm and thus should be monitoredroutinely with trans-esophageal echocardiography in patients who are planned toundergo percutaneous trans-septal mitral commissurotomy.