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Ann Thorac Surg 2008;85:313-315. doi:10.1016/j.athoracsur.2007.07.084
© 2008 The Society of Thoracic Surgeons
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Jae Hoon Lee
Suk Jung Choo
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Case Reports

Giant Left Atrial Ball Thrombus in a Patient With Chronic Nonvalvular Atrial Fibrillation

Jae Hoon Lee, MDa, Shin Kwang Kang, MDd, Cheol Whan Lee, MDb, Jae Kwan Song, MDb, Jung Sik Park, MDc, Suk Jung Choo, MDa,*

a Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
b Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
c Department of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
d Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University, Daejeon, Korea

Accepted for publication July 24, 2007.

* Address correspondence to Dr Choo, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University School of Medicine, 388-1 Poongnap-dong Songpa-gu, Seoul, 138-736, Korea (Email: sjchoo{at}amc.seoul.kr).

A 56-year-old woman with chronic nonvalvular atrial fibrillation presented with cardiac arrest during magnetic resonance imaging for back pain evaluation. Brain magnetic resonance imaging performed after cardiopulmonary resuscitation revealed multiple embolic lesions. Transesophageal echocardiography showed a large free floating thrombus ball and multiple mural thrombi in the left atrium. In light of the high-risk situation, an emergency operation was performed despite the occurrence of a fresh stroke within the previous 24 hours. The surgery was successful and the postoperative course was uneventful. The patient has been doing well since the operation on outpatient follow-up for 8 months.






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