A case of right atrial thrombus in the Chiari network after blunt cardiac rupture

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Acute Medicine & Surgery Pub Date : 2024-09-23 DOI:10.1002/ams2.70007

Takahiro Oishi, Keisuke Tamagaki, Shuhei Maruyama, Shuji Kanayama, Daiki Wada, Tomoyuki Yoshihara, Fukuki Saito, Kazuhisa Yoshiya, Yasushi Nakamori, Yasuyuki Kuwagata

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Abstract

Background

The Chiari network mostly causes no symptoms but may occasionally be involved in thrombus formation in the right atrium. We present a case of right atrial thrombus discovered in the postoperative course of blunt cardiac rupture.

Case Presentation

A 19-year-old female injured in a motor vehicle accident was transported to the hospital in a state of shock. Echocardiography revealed pericardial effusion. Cardiopulmonary arrest was imminent, so a clamshell thoracotomy was performed. A laceration at the right atrial junction of the superior vena cava was observed and sutured. Echocardiography on post-injury day 6 showed a floating thrombus in the right atrium. Anticoagulation therapy was started, the thrombus was reduced, and the patient was discharged on day 27 without sequelae. Six months later, echocardiography showed a filamentous structure and the presence of the Chiari network.

Conclusion

Right intra-atrial thrombi are rare and may warrant a search of the Chiari network in conditions where hypercoagulation is anticipated.

Abstract Image

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一例钝性心脏破裂后 Chiari 网络中的右心房血栓。

背景：Chiari网络大多不会引起任何症状，但偶尔也会参与右心房血栓的形成。我们介绍一例在心脏钝性破裂术后发现的右心房血栓病例：一名在车祸中受伤的 19 岁女性在休克状态下被送往医院。超声心动图显示心包积液。心肺骤停迫在眉睫，因此进行了开胸手术。观察并缝合了上腔静脉右心房交界处的裂口。伤后第 6 天的超声心动图显示右心房有漂浮的血栓。开始抗凝治疗后，血栓缩小，患者于第 27 天出院，没有留下后遗症。6 个月后，超声心动图显示出丝状结构和 Chiari 网络的存在：结论：右心房内血栓非常罕见，在预计会发生高凝的情况下，可能需要对Chiari网络进行检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

自引率

12.50%

发文量

审稿时长

53 weeks