Giant Left Atrial Thrombus with Double Coronary Vascularization

Introduction

Rheumatic valvular disease, especially mitral stenosis (MS) and atrial fibrillation (AF), are the main factors related to the formation of left atrial (LA) thrombi^–. Its incidence can range from 16 to 64%, and the most affected site is the left atrial appendage^,.

Systemic embolism is responsible for 10 to 45% of the complications, being the most frequent clinical presentation. Despite being rare, the mechanical mitral valve obstruction caused by thrombus may be considered as potentially severe, especially among those patients with previous MS. The clinical manifestations of this condition are variable, presenting from worsened functional class (NYHA) to cardiogenic shock.

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