Frequency of left atrial and appendage clot in patients with severe mitral stenosis.

BACKGROUND Left atrial thrombus is common in patients with mitral stenosis and atrial fibrillation; but how frequent it is in our population? The objective of study was to see the frequency of left atrial and appendage clot on trans-oesophageal echocardiography in symptomatic patients with severe mitral stenosis planned for PTMC. METHODS Trans-oesophageal echocardiographic data retrieved from computer database Cardiology department, Lady Reading Hospital, Peshawar from August 1998 to Mach 2008. Patients admitted for PTMC under went trans-oesophageal echocardiography for detection of left atrial and appendage clot and quantification of mitral regurgitation. Data was analyzed on SPSS. RESULTS Out of 1544 patients, males were 608 (39.4%), females were 936 (60.6%). Mean age was 30.84 +/- 12.6. Mean age of males was 30.56 +/- 13.1 years and females were 31.02 +/- 12.6 years. Minimum age was 8 years and maximum was 76 years. The mean LA size was 43.82 +/- 2.12 mm.Atrial fibrillation was observed in 289 (18.7%).Overall clot was seen in 224 (14.5%) patients. Left atrial appendage clot seen in 202 (89.73%).LA clot seen in 9 (4.02%). LAA/LA clot seen in 14 (6.25%). No significant difference was observed for clot among the gender distribution (p=0.42). Significant correlation was observed for clot in patients with AF and LA size > or = 45 mm, (p>0.001). CONCLUSION The frequency of left atrial and appendage clots on trans-oesophageal echocardiography in patients with severe mitral stenosis is common and more frequent in patients with AF and LA size > or = 45 mm.