Elsevier

The Annals of Thoracic Surgery

Volume 92, Issue 6, December 2011, Pages 2263-2266
The Annals of Thoracic Surgery

Case report
Pulmonary Thromboembolism in a Patient With Rheumatic Mitral Valve Stenosis: A Fortuitous Association?

https://doi.org/10.1016/j.athoracsur.2011.05.108Get rights and content

In this case report, we illustrate our experience with a patient simultaneously suffering from rheumatic mitral valve stenosis and pulmonary thromboembolism who successfully underwent mitral valve replacement and pulmonary thromboendarterectomy. Physical examination and transthoracic echocardiography revealed mitral stenosis, atrial fibrillation, and a large thrombus in the left atrium. The preoperative workup led to the diagnosis of pulmonary thromboembolism. This case emphasizes the importance of preoperative evaluation for pulmonary thromboembolism in symptomatic patients with mitral valve stenosis and atrial fibrillation.

Section snippets

Comment

Rheumatic mitral valve stenosis is still a common valvular disease in the undeveloped or developing countries. Atrial fibrillation, which is the most prevalent arrhythmia in mitral valve disease, is associated with an increased frequency of embolic events. However, the thrombus mostly occurs in the left atria, but not the pulmonary artery. In this case, we reported a patient who was first admitted for rheumatic mitral valve disease and AF. An extensive workup led to the diagnosis of PTE, not

References (7)

  • T. Watson et al.

    Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited

    Lancet

    (2009)
  • K.M. Flegel

    When atrial fibrillation occurs with pulmonary embolism, is it the chicken or the egg?

    CMAJ

    (1999)
  • Y. Yasuoka et al.

    Right atrial spontaneous echo contrast indicates a high incidence of perfusion defects in pulmonary scintigraphy in patients with atrial fibrillation

    Heart Vessels

    (2009)
There are more references available in the full text version of this article.

Cited by (0)

View full text