Journal of Postgraduate Medicine
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Year : 1979  |  Volume : 25  |  Issue : 4  |  Page : 249-250  

Left atrial thrombus in a case of prosthetic mitral valve

Lilam S Shah, AS Vengsarkar 
 Department of Cardiology, Seth G. S. Medical College and K.E.M. Hospital, Parel, Bombay-400012, India

Correspondence Address:
Lilam S Shah
Department of Cardiology, Seth G. S. Medical College and K.E.M. Hospital, Parel, Bombay-400012


A case of left atrial thrombus in Bjork Shiley mitral valve pros­thesis is reported.

How to cite this article:
Shah LS, Vengsarkar A S. Left atrial thrombus in a case of prosthetic mitral valve.J Postgrad Med 1979;25:249-250

How to cite this URL:
Shah LS, Vengsarkar A S. Left atrial thrombus in a case of prosthetic mitral valve. J Postgrad Med [serial online] 1979 [cited 2022 Aug 10 ];25:249-250
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Usefulness of echocardiography it detecting the prosthetic valve function: has been described by many authors. [1],[2],[3] Varying patterns of echoes from the same type of a prosthetic valve have caused confusion in assessing the exact status of the valve function. In this case report, an echocardiogram obtained from pros­thetic Bjork Shiley valve is reported and multiple echoes in left atrial cavity pro­bably originating from the left atria. thrombus are demonstrated.

 Case report

G. M., a 20 year old female was attending cardiology clinics since 1970. Her main com­plaints were effort intolerance, palpitations and failure to gain weight, There was history of rheumatic joint pains in the past. Clinical examination revealed moderately severe mitral regurgitation of rheumatic etiology. The patient was subjected to mitral valve replacement by prothetic Bjork Shiley valve in 1977. One year later she was readmitted with low output syn­drome and cardiac failure, which did not re­spond to medical line of treatment. She died in April 1978.

Her prosthetic mitral valve echogram showed an apparently normal functioning of the valve (See [Figure 1] on page 250A) whereas the left atrial cavity was full of thick dense echoes pro­bably from blood clots (See [Figure 2] on page 250A). Interventricular septum showed para­doxical systolic anterior motion.


Various echograms obtained from a Bjork Shiley disc valve in mitral valve position have been described by Douglas et al [1] Our case shows type D pattern [1] (See [Figure 1], on page 250A). We are unable to state whether this reflected a malfunc­tioning valve. The interventricular sep­tum showed systolic anterior motion (SAM). Left atrial cavity was full of echoes probably originating from blood clots Since post mortem studies are lack­ing in this case the status of valve func­tion could not be commented upon.


1Douglas, J. E. and Williams, G. D.: Echocardiographic - evaluation of the Bjork Shiley prosthetic valve. Circulation, 50: 52-57, 1974.
2Johnson, M. L., Hulmer, J. H. and Palton, B. C.: Echocardiographic ditermination of mitral disc valve excursion. Circulation,47: 1274-1280, 1973.
3Schuchman, H., Feigenbaum, H., Dillon, J. C. and Chang, S.: Intracavi.ory echoes in patients with mitral prosthetic valves. J. Clin. Ultrasound, 3: 111, 1975 as Quoted by Feigenbaum, H. In, "Echo­cardiography" 2nd Edition Chapter 7 on "Prosthetic Valves". Lea and Febiger, Philadelphia, 1976, p. 201.

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