Evidence map›Paper›PMID 42333363›Full record

ArticleCureus2026

A Case Report on the Pitfalls in Diagnosing Left Atrial Appendage Thrombus: Lessons From a False-Positive Transesophageal Echocardiography (TEE) in Mitral Valve Surgery.

Nicole Bianca S Libiran, Edwin Becher, Makoto Kataoka

Abstract readCase Reports
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Nicole Bianca S LibiranDepartment of Anesthesiology, Indiana University School of Medicine, Indianapolis, USA.
Edwin BecherDepartment of Anesthesiology, Indiana University School of Medicine, Indianapolis, USA.
Makoto KataokaDepartment of Anesthesiology, Indiana University School of Medicine, Indianapolis, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 47-year-old female with severe mitral stenosis underwent open mitral valve replacement. Preoperative and intraoperative transesophageal echocardiography (TEE) suggested a left atrial appendage thrombus, but no thrombus was found when the atrium was opened. While TEE is the gold standard for left atrial appendage thrombus diagnosis, its accuracy can be affected by artifacts, as well as normal anatomical structures, such as the coumadin ridge or pectinate muscle trabeculations, which may mimic thrombus, and by spontaneous echogenic contrast. Adjunct imaging techniques, including 3D TEE, left atrial appendage outflow velocity, and contrast-enhanced imaging, can improve accuracy. Cardiac CT is also a valuable alternative. In this case, the mass may have resulted from blood stasis rather than a true thrombus, highlighting the diagnostic challenges in such scenarios.

Indexed as

3d transesophageal echocardiographycardiac computed tomography (cct)echocardiographic artifactfalse-positive transesophageal echocardiographyleft atrial appendage thrombusmitral valve surgeryreverberation artifactspontaneous echocardiographic contrasttransesophageal echocardiography (tee)ultrasound enhancing agents

Identifiers

PMID42333363
PMCPMC13283740

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.