ArticleJACC. Case reports2026
A Giant Free-Floating Left Atrial Thrombus With a Flipper Effect.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
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Abstract
backgroundLeft atrial (LA) masses may be diagnostically challenging in patients with atrial fibrillation, previous mitral valve surgery, and severe LA remodeling. CASE SUMMARY: A 77-year-old woman with permanent atrial fibrillation and a bileaflet mechanical mitral prosthesis underwent pacemaker implantation. Predischarge transthoracic echocardiography revealed a large LA mass. Transesophageal echocardiography showed a heterogeneous mobile mass, raising the differential diagnosis of thrombus vs myxoma. After intravenous unfractionated heparin, repeat transesophageal echocardiography demonstrated a giant free-floating mass intermittently impinging on the prosthetic discs without increased transprosthetic gradients. Contrast-enhanced computed tomography showed no postcontrast enhancement. Urgent surgery removed the mass, which was macroscopically consistent with thrombus. DISCUSSION: Serial transesophageal echocardiography, particularly with 3-dimensional imaging, can identify dynamic changes in mass mobility and guide prompt management before embolic or prosthetic obstructive complications occur. TAKE-HOME MESSAGE: A free-floating LA thrombus near a mechanical mitral prosthesis may require urgent surgery despite normal gradient.
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