Panneerselvam Arunkumar, Bhat Prabhavathi, MohanRao Prasannasimha, Nanjappa Manjunath C
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
Department of Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
J Cardiol Cases. 2010 Oct 8;3(1):e43-e45. doi: 10.1016/j.jccase.2010.08.002. eCollection 2011 Feb.
We report the case of a 23-year-old female who underwent balloon mitral valvotomy for severe symptomatic mitral stenosis. Following septal puncture, the patient developed cardiac tamponade, which warranted sternotomy to suture the rent in the inferior vena cava-right atrial junction. The postoperative echocardiogram revealed nonhomogenous irregular opacities within the left atrium suggesting the possibility of thrombus formation. As the patient was in sinus rhythm and peri-procedural activated clotting time was in therapeutic range, clot formation was unlikely. A review of operative notes revealed placement of absorbable hemostatic gelatin sponge within the pericardium, which was mimicking left atrial clot. This potential pitfall has to be recognized in echocardiograms, as it will avoid inappropriate anticoagulant therapy.
