FOLLOW-UP OF LEFT ATRIAL THROMBI

The embolic risk and changes of thrombus location and size were invest igated in 29 consecutive patients with echocardiographically proven th rombi in the left atrium. Inclusion criteria were the visualization of a left atrial thrombus using transesophageal echocardiography. Transe sophageal follow-up echocardiograms were performed at a mean period of 18 months. In this period 6 cases of embolism were observed at an int erval of 20 days to 26 months after the detection of thrombus. Thus, t he embolic rate was 14 % per patient year. All patients received phenp rocoumon (n = 4) or aspirin at the time of embolism. Furthermore, in t wo patients after cardiac thrombectomy left atrial thrombi were seen a gain although patients were treated with anticoagulants. On the other hand, in 12 patients (5 received oral anticoagulation, 2 received aspi rin) thrombi completely resolved. It can be concluded from these data, that the majority of patients receiving anticoagulation profit from t his therapy, however, a complete protection against arterial embolism or reoccurrence of thrombi cannot be reached. Left atrial spontaneous echo contrast was the only risk factor significantly associated with t hrombembolism in patients with left atrial thrombi.