Journal of Yeungnam Medical Science

Original Article

The Predictors of Cerebral infarction in Mitral Stenosis.: Hyung Jun Kim, Woong Kim, Jong suk Lee, Gue Ru Hong, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):75-81. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.75

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Abstract PDF: BACKGROUND
Systemic embolism especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyse the some that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. METHODS: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analysis their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12months period. The patients were divided into two groups according to the presence (Group I: n=26, age: 55+/-13 years) or absence (Group II: n=101, age: 48.5+/-13 years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. RESULTS: Patients of group I were older (55.0+/-13 vs 48.5+/-13;p<0.05), had more dilated left atrial size(5.10+/-0.48 vs 4.81+/-0.70;p<0.05) and smaller mitral surface area(1.01+/-0.39 vs 1.21+/-0.45;p<0.05). In Group I, the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis, atrial fibrillation and anticoagulant therapy were the independent predictive factors. CONCLUSION: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

Case Report

A case of free-floating left atrial ball thrombus in mitral stenosis.: Young Jin Kim, Tea Il Lee, Kyo Won Choi, Seung Ho Kang, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Eun Pyo Hong; Yeungnam Univ J Med. 1993;10(1):237-244. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.237

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Abstract PDF: A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.

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