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KMID : 0904020080240010011
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Journal of Korean Society for Vascular Surgery
2008 Volume.24 No. 1 p.11 ~ p.17
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Transesophageal Echocardiography in Patients with Peripheral Artery Embolization and Cardiac Disease
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Kwun Sun-Mi
Joo Yoon-Sung
Park Ki-Hyuk
Choi Ji-Yong
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Abstract
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Purpose: In this study, we analyzed the results of transesophageal echocardiography (TEE) in acute peripheral arterial occlusion patients.
Method: Over the course of eight years, 124 patients were treated for acute peripheral artery occlusion, and 51 patients underwent transthoracic echocardiogram (TTE) and TEE postoperatively to evaluate for a possible cardiac source of thromboemboli. TEE findings in atrial fibrillation (AF) patients were compared with TEE findings in patients who had AF without thromboembolic events.
Result: AF was the most common cardiac pathology (35/51). Remnant cardiac thrombi were found in 15 patients, all in the left atrium. The average thrombus size was 1.22×0.99 cm. Surgical thrombectomy was performed in two patients, and oral anticoagulation was performed in the others. During a mean follow-up period of 38 months, 7 patients (13.7%) had recurrent thromboembolic events, even while being treated with anticoagulation. Eleven of 15 patients with remnant cardiac thrombus showed no specific clinical events during the follow-up period.
Conclusion: Remnant cardiac thrombus was found in 1/3 of patients with acute peripheral arterial occlusion caused by AF. The remnant thrombus could be safely treated with anticoagulation. Left atrial enlargement and spontaneous echogenicity were found to be risk factors for thromboembolism in AF.
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KEYWORD
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Transesophageal echcardiography, Atrial fibrillation, Acute, Arteries, , Embolism
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