Hemati Naser, Poormotaabed Alireza, Dabiri Samsam, Sabzi Feridoun
Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Tehran Heart Cent. 2015 Apr 3;10(2):109-12.
Acute left atrial thrombosis at the site of the resection of the primary cribriform septum is an exceedingly rare and important complication after atrial septal defect (ASD) closure with a pericardial or synthetic patch. This case report presents a mobile thrombus noted on the left atrium at the raw surface site of a resected cribriform primary septum that was not caught in the suture line with the pericardial patch for the closure of the ASD in a 30-year-old woman with an uncomplicated ASD surgery. The patient had no symptoms in the postoperative period, and routine postoperative transesophageal echocardiography revealed a large pedunculated and mobile mass (thrombosis) at the left atrial side of the interatrial septum at the level of the implanted pericardial patch. The thrombus was successfully treated with surgery. The patient had an uneventful recovery in the postoperative period and was discharged from the hospital 15 days after admission. One-year follow-up showed no evidence of clot recurrence in the left or right atrium.
采用心包或合成补片关闭房间隔缺损（ASD）后，原发筛状间隔切除部位出现急性左房血栓是一种极为罕见且重要的并发症。本病例报告呈现了一名30岁女性，其ASD手术顺利，在切除筛状原发间隔的创面部位的左心房发现一个活动血栓，该血栓未被心包补片关闭ASD时的缝线固定。患者术后无症状，术后常规经食管超声心动图显示，在植入心包补片水平的房间隔左房侧有一个带蒂的活动大肿块（血栓）。该血栓通过手术成功治疗。患者术后恢复顺利，入院15天后出院。一年随访显示左、右心房均无血栓复发迹象。
