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Ann Thorac Surg 2005;79:e11-e12
© 2005 The Society of Thoracic Surgeons

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Management of Left Atrial Endocardium After Extensive Thrombectomy

Cheong Lim, MDa, Won-Hee Rhyu, MDa, Young Lee, MDb, Joong Haeng Choh, MD, FACSa,*

a Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul, Korea
b Department of Thoracic and Cardiovascular Surgery, Chungnam University Hospital, Daejun, Korea

Accepted for publication September 2, 2004.

* Address reprint requests to Dr Choh, Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, 300 Kumi-dong, Bundang-ku, Seongnam-shi, Kyungki-do 463-707, South Korea (E-mail: jhcspc{at}snubh.org).

Thrombosis at the left atrium is a common phenomenon in patients with chronic mitral valve disease and atrial fibrillation. When thrombus organizes and evolves into chronic phase, clean thrombectomy can become a challenge during heart surgery because of dense adhesions and the lack of clean cleavage plane. Leaving residual thrombotic material or roughened endocardial surface after thrombectomy could be a potential source for further thrombosis and a nidus for thromboembolism. We recently managed such a patient successfully using extensive thrombectomy and endocardial coverage with a fresh autologous pericardial patch.






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