ABSTRACT
A free-floating ball thrombus in the left atrium is a rare occurrence. Few patients who developed a ball thrombus after mitral valve replacement have been reported. Our patient was a 58-year-old man who had undergone mitral valve replacement in 1981. Since bleeding gastric cancer had been diagnosed anticoagulant therapy had been 4 days before admission. On admission, echocardiography revealed a large thrombus in the left appendage. First, he underwent total gastrectomy for gastric cancer. After the operation, he developed aspiration pneumonia, and was intubated. We observed that a large thrombus had moved from the left appendage to the left atrium. Emergency operation was successfull.
ABSTRACT
We experienced a 51-year-old male case of CABG whose graftography one month after CABG revealed a 0.5cm venous bypass graft aneurysm. Anginal pain recurred in the eighth month after CABG. Re-graftography showed enlargement of the aneurysm and stenosis of the graft at the same site. Re-CABG was carried out successfully and his postoperative course was good. Venous graft aneurysm is a comparatively rare complication, and that of the present case was considered to be most ascribable to the fragility of the graft, caused by mediastinitis secondary to the first CABG. Thrombus formation was noted in the aneurysm, with a risk of causing rupture or myocardial infarction. Therefore, such graft aneurysms should be treated by re-CABG as soon as possible after detection.