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NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!

Yıl 2017, Cilt: 7 Sayı: 4, 100 - 103, 13.12.2017

Öz

Nonvalvüler atriyal fibrilasyon (NVAF) erişkinlerde en sık görülen sürekli aritmidir ve kusurlu

atriyal kontraksiyonların sonucu atriyal trombüs oluşumuna neden olabilir. Sol-taraflı kardiyak

trombüsler genellikle miyokard enfarktüsü, dilate kardiyomiyopati veya mitral kapak hastalığı ile

ilişkilidir. Öte yandan sağ taraflı kardiyak trombüsler sekonder nedenlerden oluşabilir, daha az

görülür ve literatürde birkaç sağ atriyal trombüs vaka raporu bildirilmiştir (1,2).

Sürekli AF hikayesi olan 72 yaşındaki kadın hasta, nefes darlığı yakınması nedeniyle kliniğimize

başvurdu. Transözefagial ekokardiyografi de (TÖE), sağ atriyal apendikste 1.5x4.0 cm boyutunda

trombüs ile birlikte her iki atriumda da spontan eko kontrast (SEK) bulgusu izlendi. Sol atriyum

(SA) ve sol atriyal appendiks (SAA) taramasında herhangi bir trombüse rastlanmadı. Bu olgu

sunumunda; NVAF’a tedavi yaklaşımını belirlemeden önce transözofageal ekokardiyografi ile

SAA’in yanı sıra sağ atriyal apendiks muayenesinin de dikkatle yapılması gerektiğini vurgulamayı

amaçladık.

Anahtar Sözcu¨kler: Atrial fibrilasyon; Sağ atrium; Trombüs


ABSTRACT

Nonvalvular atrial fibrillation (NVAF) is the most common sustained arrhythmia in adults and

result of defective atrial contractions may cause atrial thrombi formation. Left-sided cardiac

thrombi are often associated with myocardial infarction, dilated cardiomyopathy or mitral valve

disease. On the other hand, right-sided cardiac thrombi may consist of secondary causes, less

often seen and a few case reports of right atrial (RA) thrombus have been described in the

literatüre(1,2).

A 72 year-old woman with permanent AF history was admitted to our clinic because of worsening

complaint of dyspnea. TEE revealed spontaneous echo contrast (SEC) in both atria with the

presence of thrombus 1.5x4.0 cm in size from right atrial appendage (RAA). No thrombus

detected during screening of left atrium (LA) and left atrial appandage (LAA). In this case report;

we aimed to emphasise that transesophageal echocardiography (TEE) examination of the RAA

should be done carefully before deciding the treatment modality in nonvalvular AF as well as

LAA.

Keywords: Atrial fibrillation, Right atrium; Thrombus

Kaynakça

  • 1. Nugert GR, Lucus R, Judy M, et al. Thromboembolic complications in ventriculoatrial shunts. J Neurosurg 1966; 24:34-36. 2. London AR, Runge PJ, Balsin RF, et al. Large right atrial thrombi surrounding permanent transvenous pacemaker. Circulation 1969; 39:661-664. 3. de Divitiis M, Omran H, Rabahieh R, et al. Right atrial appendage thrombosis in atrial fibrillation: its frequency and its clinical predictors. Am J Cardiol. 1999;84:1023-1028 4. Rozenberg V, Boccara F, Benhalima B, et al. Comparison of echocardiographic markers of embolism in atrial flutter and fibrillation:frequency of protruding atherosclerotic plaques in the thoracic aorta. Echocardiography. 2000;17:555-562. 5. Subramaniam B, Riley MF, Panzica PJ, et al. Transesophageal echocardiographic assessment of right atrial appendage anatomy and function: comparison with the left atrial appendage and implications for local thrombus formation. J Am Soc Echocardiogr. 2006;19:429-433. 6. Willoughby SR, Roberts-Thomson RL, et al. Atrial platelet reactivity in patients with atrial fibrillation. Heart Rhythm.; 2010;7(9): 1178-1183. 7. Bilge M, Eryonucu B, Güler N, et al. Right Atrial Appendage Function in Patients with Chronic Nonvalvular Atrial Fibrillation. Jnp Heart J. 2000 Jul;41(4):451-462. 8. Manning WJ, Silverman DI, Keighley CS, et al. Transesophageal echocardiographically facilitated early cardioversion from atrial fibrillation using short-term anticoagulation: final results of a prospective 4.5-year study. J Am Coll Cardiol. 1995;25:1354-1361. 9. Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. 2001;344:1411-1420. 10. Sahin T, Ural D, Kilic T,et al.Right atrial appendage function in different etiologies of permanent atrial fibrillation: a transesophageal echocardiography and tissue Doppler imaging study. Echocardiography; 2010; 27(4):384-393
Yıl 2017, Cilt: 7 Sayı: 4, 100 - 103, 13.12.2017

Öz

Kaynakça

  • 1. Nugert GR, Lucus R, Judy M, et al. Thromboembolic complications in ventriculoatrial shunts. J Neurosurg 1966; 24:34-36. 2. London AR, Runge PJ, Balsin RF, et al. Large right atrial thrombi surrounding permanent transvenous pacemaker. Circulation 1969; 39:661-664. 3. de Divitiis M, Omran H, Rabahieh R, et al. Right atrial appendage thrombosis in atrial fibrillation: its frequency and its clinical predictors. Am J Cardiol. 1999;84:1023-1028 4. Rozenberg V, Boccara F, Benhalima B, et al. Comparison of echocardiographic markers of embolism in atrial flutter and fibrillation:frequency of protruding atherosclerotic plaques in the thoracic aorta. Echocardiography. 2000;17:555-562. 5. Subramaniam B, Riley MF, Panzica PJ, et al. Transesophageal echocardiographic assessment of right atrial appendage anatomy and function: comparison with the left atrial appendage and implications for local thrombus formation. J Am Soc Echocardiogr. 2006;19:429-433. 6. Willoughby SR, Roberts-Thomson RL, et al. Atrial platelet reactivity in patients with atrial fibrillation. Heart Rhythm.; 2010;7(9): 1178-1183. 7. Bilge M, Eryonucu B, Güler N, et al. Right Atrial Appendage Function in Patients with Chronic Nonvalvular Atrial Fibrillation. Jnp Heart J. 2000 Jul;41(4):451-462. 8. Manning WJ, Silverman DI, Keighley CS, et al. Transesophageal echocardiographically facilitated early cardioversion from atrial fibrillation using short-term anticoagulation: final results of a prospective 4.5-year study. J Am Coll Cardiol. 1995;25:1354-1361. 9. Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. 2001;344:1411-1420. 10. Sahin T, Ural D, Kilic T,et al.Right atrial appendage function in different etiologies of permanent atrial fibrillation: a transesophageal echocardiography and tissue Doppler imaging study. Echocardiography; 2010; 27(4):384-393
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Bölüm Olgu Sunumu
Yazarlar

Şiho Hidayet

Ferhat Eyyüpkoca Bu kişi benim

Yılmaz Ömür Otlu Bu kişi benim

Erdoğan Yaşar Bu kişi benim

Yayımlanma Tarihi 13 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 7 Sayı: 4

Kaynak Göster

APA Hidayet, Ş., Eyyüpkoca, F., Otlu, Y. Ö., Yaşar, E. (2017). NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!. Bozok Tıp Dergisi, 7(4), 100-103.
AMA Hidayet Ş, Eyyüpkoca F, Otlu YÖ, Yaşar E. NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!. Bozok Tıp Dergisi. Aralık 2017;7(4):100-103.
Chicago Hidayet, Şiho, Ferhat Eyyüpkoca, Yılmaz Ömür Otlu, ve Erdoğan Yaşar. “NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association With Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!”. Bozok Tıp Dergisi 7, sy. 4 (Aralık 2017): 100-103.
EndNote Hidayet Ş, Eyyüpkoca F, Otlu YÖ, Yaşar E (01 Aralık 2017) NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!. Bozok Tıp Dergisi 7 4 100–103.
IEEE Ş. Hidayet, F. Eyyüpkoca, Y. Ö. Otlu, ve E. Yaşar, “NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!”, Bozok Tıp Dergisi, c. 7, sy. 4, ss. 100–103, 2017.
ISNAD Hidayet, Şiho vd. “NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association With Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!”. Bozok Tıp Dergisi 7/4 (Aralık 2017), 100-103.
JAMA Hidayet Ş, Eyyüpkoca F, Otlu YÖ, Yaşar E. NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!. Bozok Tıp Dergisi. 2017;7:100–103.
MLA Hidayet, Şiho vd. “NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association With Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!”. Bozok Tıp Dergisi, c. 7, sy. 4, 2017, ss. 100-3.
Vancouver Hidayet Ş, Eyyüpkoca F, Otlu YÖ, Yaşar E. NONVALVÜLER ATRİYAL FİBRİLASYON İLE İLİŞKİLİ SAĞ ATRİYAL APENDİKSTE TROMBÜS: ASLA SAĞ ATRİYAL APENDİKSİ UNUTMAYIN! A Thrombus in Right Atrial Appendage in Association with Nonvalvular Atrial Fibrillation: Never Forget Right Atrial Appendage!. Bozok Tıp Dergisi. 2017;7(4):100-3.
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