[Transthoracic and transesophageal follow-up in patients with left atrial thrombosis].

The embolic risk and changes of thrombus location and size were investigated in 29 consecutive patients with echocardiographically proven thrombi in the left atrium. Inclusion criteria were the visualization of a left atrial thrombus using transesophageal echocardiography. Transesophageal follow-up echocardiograms were performed at a mean period of 18 months. In this period 6 cases of embolism were observed at an interval of 20 days to 26 months after the detection of thrombus. Thus, the embolic rate was 14% per patient year. All patients received phenprocoumon (n = 4) or aspirin at the time of embolism. Furthermore, in two patients after cardiac thrombectomy left atrial thrombi were seen again although patients were treated with anticoagulants. On the other hand, in 12 patients (5 received oral anticoagulation, 2 received aspirin) thrombi completely resolved. It can be concluded from these data, that the majority of patients receiving anticoagulation profit from this therapy, however, a complete protection against arterial embolism or reoccurrence of thrombi cannot be reached. Left atrial spontaneous echo contrast was the only risk factor significantly associated with thromboembolism in patients with left atrial thrombi.