Percutaneous Balloon Mitral Valvuloplasty and Early Right Atrial Clot Formation: A Case Report

  • Rezvaniyeh Salehi Cardiovascular Research Center, Tabriz University of Medical Sciences
  • Naser Aslan Abadi Cardiovascular Research Center, Tabriz University of Medical Sciences
  • Razieh Parizad Cardiovascular Research Center of Tabriz University of Medical Sciences
  • Sanam Mirzayi Cardiovascular Research Center, Tabriz University of Medical Sciences
  • Elnaz Javanshir Mail Cardiovascular Research Center, Tabriz University of Medical Sciences
Keywords:
Mitral valve stenosis, Balloon valvuloplasty, Thrombosis, Anticoagulant

Abstract

Percutaneous balloon mitral valvuloplasty (PBMV) has recently become the treatment of choice for many patients suffering from mitral stenosis. In the current report, we introduce a 26-year-old woman who presented to us with palpitation and exertional dyspnea but without any remarkable medical history. ECG illustrated the sinus rhythm, transthoracic echocardiography (TTE) showed severe rheumatic mitral stenosis and (2+) mitral regurgitation, and transesophageal echocardiography (TEE) demonstrated severe mitral stenosis and no thrombus. Accordingly, the patient underwent percutaneous transvenous mitral commissurotomy (PTMC). On the following day, TTE showed a fresh mobile thrombus in the right atrium attached to the atrial septum, which was confirmed by TEE. As a result, the patient received 1 mg/kg (60 mg) of enoxaparin subcutaneously twice daily plus 5 mg of warfarin daily. Subsequent TTE revealed no mass 4 days after the treatment. Evidence suggests that endocardial surface injury and trans-septal puncture during PTMC may be associated with clot formation, which is aggravated by low blood flow in the right atrium and the catheter as a foreign body. This case report emphasizes the importance of post-PTMC anticoagulant therapy.

References

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Published
2020-04-30
How to Cite
1.
Salehi R, Aslan Abadi N, Parizad R, Mirzayi S, Javanshir E. Percutaneous Balloon Mitral Valvuloplasty and Early Right Atrial Clot Formation: A Case Report. J Tehran Heart Cent. 15(2):77-80.
Section
Case Report(s)