Trans-oesophageal Echocardiographic Appraisal of Left Atrial Appendage Clot in Severe Mitral Stenosis.

Authors

  • Rabindra Simkhada Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu
  • Man Bahadur KC Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Yadav Deo Bhatt Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Arun Maskey Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Rabi Malla Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Deewakar Sharma Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Rajeeb Rajbhandari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Yuba Raj Limba Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Subodh Kansakar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Sajan Gopal Baidhya Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Ranjit Shama Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Himanshu Prasad Nepal Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Binay Kumar Rauiyar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Dharma Nath Yadav Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Dipanker Prajapati Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Rabindra Pandey Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Nagma Shrestha Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,
  • Satish Kumar Singh Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu,

DOI:

https://doi.org/10.3126/njh.v10i1.9744

Keywords:

Left atrial appendage clot, Mitral stenosis, Trans-oesophageal echocardiogram

Abstract

Background and Aims Left atrial appendage clot is a common complication of mitral stenosis. The management of patient differs significantly if there is presence of clot. Various factors had been studied as a risk factor for clot formation. We aim to assess the prevalence of left atrial appendage clot by trans-oesophageal echocardiography in patients of severe mitral stenosis planned for percutaneous transvenous mitral commissurotomy and analyze the factors responsible for it.

Methods: An oservational prevalence study was conducted among 100 patients of severe mitral stenosis who were undergoing transoesophageal echocardiography before percutaneous transvenous mitral commissurotomy and prevalence of left atrial appendage clot were recorded. Data were entered in the SPSS and factors responsible for clot formation were analyzed.

Results: Out of 100 enrolled patients, 69 (69%) were female. Mean age of presentation was 37.4±13.70 years. Mean age of female was 38.11±13.13 years and male was 35.80±14.98 years. Mean mitral valve area was 0.87±0.12 cm2 and mean left atrial size was 4.79±0.60 cm. Atrial Fibrillation was present in 32 (32%) patients. Transoesophageal echocardiography revealed left atrial appendage clot in 28 (28%). Gender showed no correlation with presence of clot (p=0.06). Increasing age (p=0.002), presence of Atrial Fibrillation (p=0.005) and larger left atrial size (p<0.01) showed significant positive correlation with left atrial appendage clot formation.

Conclusion: Left atrial appendage clot was common finding in severe mitral stenosis patients. Patients with advanced age, presence of atrial fibrillation and larger left atrial size were more likely to have clot formation.

Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 27-29

DOI: http://dx.doi.org/10.3126/njh.v10i1.9744

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Published

2014-02-01

How to Cite

Simkhada, R., KC, M. B., Bhatt, Y. D., Maskey, A., Malla, R., Sharma, D., Rajbhandari, R., Limba, Y. R., Kansakar, S., Baidhya, S. G., Shama, R., Nepal, H. P., Rauiyar, B. K., Yadav, D. N., Prajapati, D., Pandey, R., Shrestha, N., & Singh, S. K. (2014). Trans-oesophageal Echocardiographic Appraisal of Left Atrial Appendage Clot in Severe Mitral Stenosis. Nepalese Heart Journal, 10(1), 27–29. https://doi.org/10.3126/njh.v10i1.9744

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Original Articles