Fujiwara Mikiko, Watanabe Hiroyuki, Oguma Yasunori, Yamaura Genbu, Ishibashi Kazuyuki, Yamamoto Hiroshi, Nobori Kiyoshi, Iino Kenji, Yamamoto Fumio, Ito Hiroshi
Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Hondoh 1-1-1, Akita 010-8543, Japan.
Heart Vessels. 2012 Jul;27(4):428-31. doi: 10.1007/s00380-011-0199-0. Epub 2011 Nov 2.
Free-floating left atrial thrombi are rare. Here we report a case of a 75-year-old woman with atrial fibrillation who was admitted for treatment of acute myocardial infarction. A free-floating left atrial thrombus was found incidentally on echocardiography. Ten days after percutaneous coronary intervention, the patient had mild faintness with transient hypotension, and it was found that the left atrial thrombus had developed intermittent entrapment in the mid-ventricle during diastole, with abrupt rebound back to the left atrial cavity during systole. Urgent removal of the thrombus was performed successfully. Although the free-floating thrombus had appeared to be spherical, like a ball thrombus, on echocardiography, the excised thrombus was pedunculated. A cut section revealed a laminated thrombus with an onion-skin-like appearance.
游离性左心房血栓较为罕见。在此，我们报告一例75岁心房颤动女性患者，因急性心肌梗死入院治疗。经超声心动图偶然发现一枚游离性左心房血栓。经皮冠状动脉介入治疗10天后，患者出现轻度头晕伴短暂低血压，发现左心房血栓在舒张期于心室中部出现间歇性嵌顿，收缩期突然回弹至左心房腔。成功实施了血栓紧急清除术。尽管在超声心动图上，游离性血栓看似呈球形，类似球形血栓，但切除的血栓有蒂。切面显示为具有洋葱皮样外观的分层血栓。
