Perioperative challenges in a pregnant patient having large left atrial clot: A case report. | ||||
| Ain-Shams Journal of Anesthesiology | ||||
| Volume 16, Issue 1, 2024 PDF (261.05 K) | ||||
| Document Type: Case report | ||||
| DOI: 10.21608/asja.2024.249520.1005 | ||||
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| Authors | ||||
Lalit Jha; Rajnish Kumar   ; Amarjeet Kumar; Saras Singh
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| AIIMS Patna | ||||
| Abstract | ||||
| Background Left atrial thrombus during pregnancy in mitral valve replacement status case is a rare condition. Large left atrial clots pose perioperative challenges like hemodynamic instability, arrhythmia, and thromboembolic events. We are going to describe the anesthetic management in a patient having a large left atrial thrombus. Case presentation: We report a 25-year-old pregnant patient who presented at 19 weeks of her first pregnancy with breathing difficulty. The mitral valve replacement was done four years ago with a Medical mechanical heart valve for severe rheumatic mitral stenosis with pulmonary arterial hypertension. Although she had been prescribed anticoagulation medications post-surgery, She had discontinued them for past 2 months and subsequently presented with atrial fibrillation with a large left atrial clot. She underwent two emergency non-cardiac surgeries under general anesthesia. Conclusions: We conclude that the post-mitral valve replacement status patient in cardiac failure with a large left atrial clot and atrial fibrillation requires immediate and aggressive medicinal or surgical care due to the life-threatening nature of the situation. | ||||
| Keywords | ||||
| Mitral valve replacement; Left atrial clot; Pregnancy | ||||
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