An unusual intracardiac thrombus in an 81-year-old man with severe symptomatic aortic stenosis

A 81-year-old male patient with chronic obstructive lung disease, decompensated severe calcified aortic stenosis, moderately to severely reduced biventricular systolic function, and atrial fibrillation with secondary pulmonary hypertension was referred to our institution. He was treated with diuretics, oral anticoagulants followed by low dose beta blocker. After cardiac recompensation coronary artery disease was excluded by coronary angiogram. Computed tomography (CT) angiography was performed prior to transcatheter aortic valve replacement (TAVR). Unexpectedly, CT (Panel C) and transthoracic echocardiography without contrast (Panel A; Supplementary material onlineSupplementary material online,Video S1) and with contrast (Panel B) revealed a mass (14 ×13 mm) in the coronary sinus. This mass dissolved under anticoagulation, confirming the suspected coronary sinus thrombus (CST) (Panel D).
Source: European Heart Journal - Category: Cardiology Source Type: research