In this case report, sedation for central vein catheterization a girl patient who having severe congestive heart failure with huge
mural thrombus in left ventriculus has been presented.
Left ventricular mural thrombus is a well-recognized complication of acute myocardial infarction.
In fact, left ventricular embolism after myocardial infarction resulting in stroke, bowel, and limb ischemia has been reported in literature8 In survivors of myocardial infarction with an LV mural thrombus, systemic embolization occurs in about 10%9.
Left atrial thrombus, and LV
mural thrombus were observed in 5 (5%) and 14 (14%) patients, respectively.
This device is contraindicated in patients with active systemic infection, those with an intracardiac
mural thrombus, or those who have had a ventriculotomy or atriotomy in the preceding 4 weeks, and in patients with cryoglobulinemia.
Thrombotic causes for catheter obstruction include intraluminal thrombus, extraluminal fibrin sleeve,
mural thrombus, or major vessel occlusion and present as either complete or partial occlusion (Hadaway, 1998).
Tissue characterisation was consistent with apical wall oedema, which had reduced significantly in size since the previous CMR, and complete resolution of the left ventricular apical
mural thrombus and pleural effusions (Figure 3).
Severe mitral regurgitation may prevent
mural thrombus formation within the left ventricle with systolic dysfunction.
An abdominal ultrasound can delineate the transverse and longitudinal dimensions of an abdominal aortic aneurysm and may detect
mural thrombus. CT with contrast and MRI are accurate, noninvasive tests to determine the location and size of abdominal aortic aneurysms and to plan endovascular or open surgical repair.
Balloon angioplasty was also performed to treat the residual
mural thrombus and persistent stenosis in the axillary and subclavian veins.
Other recent technical modalities can also be used for optimal imaging in the workup such as echocardiography, MRI, and spiral CT which can demonstrate the patent lumen and detect any
mural thrombus or other abnormalities of the vessel wall [1, 7].
Although the exact pathogenesis of cardiac CAT is not determined, some authors believe the hypothesis that cardiac CAT is an organized and calcified
mural thrombus [8].