The Factors Causing Left Atrial Appendage Clot Formation in Patients With Severe Rheumatic Mitral Stenosis.
Rheumatic mitral stenosisis still present in the developing world. Left atrial appendage clot is a common complication of mitral stenosis. The management differs significantly if there is presence of clot.
Mitral stenosis can lead to enlargement of the left atrium (LA) leading to increased risk of thrombus formation. The frequency of left atrial thrombi is between 20 and 33% according to the literature. Left atrial thrombus is more frequently associated with embolic events. The accessibility of the left atrial appendage by transesophageal echocardiography(TEE) is better than transthoracic echocardiography (TTE) for detection of clot. We designed this study to evaluate various echocardiographic predictors for LA clot in patients with severe mitral stenosis.
Our study supported that the severity of mitral stenosis was significantly related with thrombus formation as smaller the mitral valve area was. Ozkan et al found similar results.15 Similarly the frequency of Left atrial thrombus increases with atrial fibrillation and low flow velocities. Fazlinez had et al found that patients with left atrial thrombus had more LA appendage dysfunction, more frequent atrial fibrillation and smaller mitral valve area. Our study also supported that atrial fibrillation was significantly associated with thrombus formation (p≤0.05). Ali et al., found similar results in patients of rheumatic mitral stenosis3 and found that 60% of patients had LA thrombus. Guleretal.18 found that Left atrialsize was significantly higher in patients with low emptying velocities.
The frequency of left atrial thrombus formation increased in patients with rheumatic mitral stenosis because of low left atrial appendage flow velocities, atrial fibrillation and smaller mitral
valve area.
Heart Res Open J. 2016; 3(1): 1-5. doi: 10.17140/HROJ-3-127
