Most organized myocardial thrombi appear as a left atrial mass in patients with rheumatic mitral stenosis and atrial fibrillation. Right atrial thrombi in the absence of atrial fibrillation have been associated with amplatzer occluders for atrial septal defects. We present images of a patient with a thrombotic right atrial mass without any underlying risk factors.A 70‐year‐old female was referred for evaluation of a spherical, calcified mass seen on a routine chest X‐ray (arrow in Figure A). There was no history of atrial fibrillation, valvular disease, or previous cardiac surgery. Her physical examination was unremarkable and an electrocardiogram showed normal sinus rhythm. A transthoracic echocardiogram (TTE) showed a 4 × 3 × 2.5‐cm mobile right atrial mass (Figure B). A contrast‐enhanced computed tomography scan showed an extensively calcified right atrial mass (Figure C). A coronary angiogram showed an avascular mass without any coronary artery disease (Figure D). At the time of surgery, following initiation of cardiopulmonary bypass and cardiac arrest, the right atrium was opened and a 5 × 4 × 3‐cm eggshaped mass with a fibrous pedicle was noted to be attached to the interatrial septum inferior to the fossa ovalis. The mass was easily excised and the septum remained intact. The patient tolerated the procedure well
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
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