• Mahmood ul Hassan
  • Cheragh Hussain
  • Adnan Mahmood Gul
  • Hikmat ullah Jan
  • Mohammad Hafizullah


Background: Left atrial thrombus is common in patients with mitral stenosis and atrial fibrillation; buthow frequent it is in our population? The objective of study was to see the frequency of left atrial andappendage clot on trans-oesophageal echocardiography in symptomatic patients with severe mitralstenosis planned for PTMC. Methods: Trans-oesophageal echocardiographic data retrieved fromcomputer database Cardiology department, Lady Reading Hospital, Peshawar from August 1998 toMach 2008. Patients admitted for PTMC under went trans-oesophageal echocardiography for detectionof left atrial and appendage clot and quantification of mitral regurgitation. Data was analyzed on SPSS.Results: Out of 1544 patients, males were 608 (39.4%), females were 936 (60.6%). Mean age was30.84±12.6. Mean age of males was 30.56±13.1 years and females were 31.02±12.6 years. Minimumage was 8 years and maximum was 76 years. The mean LA size was 43.82±2.12mm.Atrial fibrillationwas observed in 289 (18.7%).Overall clot was seen in 224 (14.5%) patients. Left atrial appendage clotseen in 202 (89.73%).LA clot seen in 9 (4.02%). LAA/LA clot seen in 14 (6.25%). No significantdifference was observed for clot among the gender distribution (p=0.42). Significant correlation wasobserved for clot in patients with AF and LA size ≥45 mm, (p>0.001). Conclusion: The frequency ofleft atrial and appendage clots on trans-oesophageal echocardiography in patients with severe mitralstenosis is common and more frequent in patients with AF and LA size ≥45 mm.Keywords: LA, LAA, CLOT, TEE, PTMC


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