[A case of left atrial ball thrombus observed in a patient with combined valvular heart disease, accompanying anomalous coronary venous run].

A 53-year woman, who had been under observation for combined valvular heart disease, was admitted to our hospital for further examination of embolic episodes to brain and kidney. Echocardiographic examination showed the evidence of free-moving ball thrombus in the left atrium, and emergent cardiac catheterization following the echocardiography confirmed the diagnosis of it as well as mitral stenosis, aortic regurgitation with stenosis, and tricuspid regurgitation. In addition, coronary angiography disclosed the anomalous coronary venous run. With these findings, the cause of embolic episodes was found to be due to the thrombus in the left atrium. In the surgery performed a ball thrombus of 40 x 35 x 36 mm and a mural thrombus of 15 x 35 x 20 mm in size in the left atrium were detected and removed, and both mitral and aortic valves were replaced to artificial ones. She had a good hospital course after the surgery and discharged without any complication. In this report, we discussed a case of left atrial thrombus observed in a combined valvular heart disease, with 29 literatures reported in our country.