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Accidental left atrial appendage thrombus detected by intraoperative transesophageal echocardiography during coronary artery bypass graft -A case report-
Anesth Pain Med 2016;11(4):389-92
Published online October 31, 2016
© 2016 The Korean Society of Anesthesiologists.

Joo Hyun Jun, Mi Hyeon Lee, Eun Mi Choi, Eun-mi Kim, Hyo-Keun Lee, Seyng Hwa Baek, and Mi-Hwa Chung
Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
Correspondence to: Mi-Hwa Chung, M.D., Ph.D., Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5230, Fax: 82-2-345-1571, E-mail: mhchung20@hanmail.net
Received April 11, 2016; Revised August 18, 2016; Accepted August 18, 2016.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

A 77-year-old woman was scheduled for a coronary artery bypass graft. Her preoperative transthoracic echocardiographic (TTE) examination revealed an enlarged left atrium with reduced systolic dysfunction (ejection fraction: 38%), moderate global hypokinesia of the left ventricle, and moderate mitral and tricuspid regurgitation. No thrombus was visualized on the preoperative TTE. However, the intraoperative transesophageal echocardiography performed before the cardiopulmonary bypass revealed a thrombus of approximately 1.3 × 1.8 cm in the left atrial appendage (LAA). The LAA thrombus was removed, an internal suture was placed on the LAA before the coronary artery bypass grafting, and the main operation was performed successfully. The patient was transferred to the intensive care unit to receive postoperative care. She was extubated 4 h after the surgery and was transferred to the general ward on postoperative day 3 without any neurological sequelae.

Key Words : Atrial appendage, Thrombosis, Transesophageal echocardiography


April 2019, 14 (2)
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