Massive thrombus originating from the interatrial septum and prolapsing into the left ventricle

Excerpt

Atrial fibrillation (AF) results in loss of mechanical contraction of the left atrium (LA) leading to slow flow velocities in the LA and left atrial appendix, which ends with thrombus formation and risk of systemic embolism [1]. Thrombus inside the left atrial cavity is usually localized in the appendix, while a ball-shaped thrombus generally originates from the interatrial septum [2, 3]. A ball thrombus in the left atrium was first reported by Wood in 1814 at the autopsy of a 15-year-old girl with mitral stenosis [4]. A ball-shaped thrombus is extremely rare in the absence of mitral valve disease and was first described in 1992 [2, 5, 6]. A ball-shaped thrombus carries a high risk of systemic embolism and because it does not respond to anticoagulation in the acute phase, surgical thrombectomy is the first line of treatment, making this condition clinically important [7]. …