Resolution of Left Atrial Thrombi with Anticoagulant Therapy in Candidates for Percutaneous Transvenous Mitral Commissurotomy
Songkwan Silaruks MD, Songsak Kiatchoosakun MD, Wirote Tantikosum MD, Chaiyasith Wongvipaporn MD, Pyatat Tatsanavivat MD, Virat Klungboonkrong MD, Bandit Thinkhamrop PhD

A prospective cohort study was conducted to estimate the resolution rate of documented left atrial thrombus (LAT) among 75 candidates for percutaneous transvenous mitral commissurotomy undergoing oral anticoagulant therapy prior to the procedure, and to determine its significant predictors. The fate of LAT was studied serially with both transthoracic and transesophageal echocardiography. The LAT completely resolved in 48 patients during 914 patient-months observed (5.25 per 100 patient-months; 95% CI 3.96-6.97). The median duration of LAT resolution was 16 months, with an overall resolution rate of 63.0 per 100 patients per year. The significant predictors of LAT resolution were its smaller size and lesser severity of the left atrial spontaneous echo contrast.