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Diagnosis of a huge right atrial thrombus during coronary artery bypass graft surgery

Omer Senarslan, Mustafa Zungur, ─░hsan Sami Uyar, Samet Uyar, Talat Tavli, Emin Alp Alayunt

(Izmir, Turkey)

Am J Case Rep 2013; 14:388-390

DOI: 10.12659/AJCR.889327

Background: Intra-operative formation of a thrombus in the right heart is rare and might be unrecognized. However, it can be associated with severe consequences, including pulmonary embolism and death.
Case Report: We report the case of a 73-year-old man who presented to the cardiologist with angina pectoris and rare shortness of breath. Coronary artery bypass grafting (CABG) was performed due to multi-vessel disease. Because of hemodynamic insufficiency, an intra-operative transesophageal echocardiogram (TEE) was performed and a huge free-floating thrombus was detected. Multiple thrombi were removed from the right heart and pulmonary arteries. The patient died after cardiopulmonary bypass support and 12 hours of intensive care.
Conclusions: In this case report, we emphasize the importance of the TEE during the preoperational period and during CABG, as well as in the preoperative evaluation of pulmonary hypertension.

Keywords: coronary artery bypass grafting, Intra-operative Transesophageal Echocardiography, thromboembolism

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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