Left Atrial Appendage Occlusion

Left atrial appendage (laa) occlusion is a treatment strategy toprevent blood clot formation in atrial appendage. although, laaocclusion usually was done by catheter?based techniques, especiallypercutaneous trans?luminal mitral commissurotomy (ptmc), it can bedone during closed and open mitral valve commissurotomy (cmvc,omvc) and mitral valve replacement (mvr) too. nowadays,ptmc is performed as an optimal management of severe mitralstenosis (ms) and many patients currently are treated by ptmcinstead of previous surgical methods. one of the most importantcontraindications of ptmc is presence of clot in laa. so, eachpatient who suffers of severe ms is evaluated by trans?esophagealechocardiogram to rule out thrombus in laa before ptmc. atopen heart surgery, replacement of the mitral valve was performedfor 49?year?old woman. also, left atrial appendage occlusion wasdone during surgery. immediately after surgery, echocardiographydemonstrates an echo imitated the presence of a thrombus inleft atrial appendage area, although there was not any evidenceof thrombus in pre?pump tee. we can conclude from thiscase report that when we suspect of thrombus of left atrial, weshould obtain exact history of previous surgery of mitral valveto avoid misdiagnosis clotted laa, instead of obliterated laa.consequently, it can prevent additional evaluations and treatmentssuch as oral anticoagulation and exclusion or postponing surgeriesincluding ptmc.