RESOLUTION OF LEFT ATRIAL THROMBUS IN SEVERE MITRAL STENOSIS PATIENTS AFTER THREE MONTHS OF ANTICOAGULATION

Authors

  • Fayaz Ali 1. National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan
  • Kanwal Fatima Aamir National Institute of Cardiovascular Diseases, Rafiqui (H.J.) Shaheed Road, 75510, Karachi, Pakistan
  • Asif Nadeem Armed Forces Institute of Cardiology & National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi-Pakistan
  • Rehmat Ghafar Hayatabad Medical Complex, Peshawar-Pakistan
  • Mahmood ul Hassan Hayatabad Medical Complex, Peshawar-Pakistan
  • Parveen Akhtar National Institute of Cardiovascular Diseases, Rafiqui (H.J.) Shaheed Road, 75510, Karachi, Pakistan
  • Samra Yasmin Haque Punjab Institute of Cardiology, Lahore-Pakistan
  • Shirjeel Murtaza Punjab Institute of Cardiology, Lahore-Pakistan
  • Fateh Ali Tipoo Aga Khan University Hospital, Karachi-Pakistan
  • Ishtiaq Rasool Fazaia Ruth Pfau Medical College, Karachi-Pakistan
  • Tariq Ashraf Karachi Institute of Heart Diseases, Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v55i4.2327

Abstract

Objectives: To determine frequency of LA clot resolution in patients with severe MS after three months of anticoagulation.

Methodology: A descriptive study was conducted over 6 months from Jul 2018 to Jan 2019 including 49 patients who fulfilled the inclusion criteria and visited Cardiology department, NICVD Hospital-Karachi. After clinical evaluation, warfarin therapy was given for 3 months followed by Transesophageal echocardiography (TEE) to access the resolution of LA thrombus. Chi-square test and Fisher Exact test were used to assess the effect of patient characteristics and echocardiographic findings on the resolution of thrombus.

Results: The mean age of the study patients was 47.51±9.93 years. The average mitral valve area (cm2) was observed to be 0.68±0.16, while the average size of left atrial (mm) was 54.38±7.19. At the end of 2 months, TEE showed successful resolution of clot in 11 (22.4%). While by the end of 3 months, only 6 (12.2%) patients showed successful resolution of clot.

Conclusion: After 3 months of oral anticoagulation, the LA thrombus resolved in almost 1/4th of the study patients. Successful clot resolution showed positive correlation with history of stroke, hemoptysis and clot mobility and negative correlation with severity of tricuspid regurgitation.

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Published

2022-12-31

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Original Article