Detection of left atrial thrombi by two-dimensional echocardiography and surgical correlation in 148 patients with mitral valve disease

Left atria1 (LA) thrombus has long been recognized as a complication of rheumatic mitral valve disease.^1-4 Until the development of 2-dimensional echocardiography, these thrombi were rarely diagnosed before surgery. There have been few published reports^3,4 regarding the utility of 2-dimensional echocardiography in the detection of LA thrombi, and the sensitivity and specificity of 2-dimensional echocardiography in detecting them remain uncertain. We undertook a review of all adult patients undergoing mitral valve replacement during a 64-month period to determine (1) the sensitivity and specificity of 2-dimensional echocardiography in detecting LA thrombi; (2) the location and attachment of the thrombi, (3) whether LA thrombi can form in mitral valve disease other than rheumatic mitral stenosis; (4) the clinical features associated with the development of LA thrombi, that is, the presence of atria1 fibrillation and LA size; and (5) whether the presence of thrombus is associated with embolic events.