A ball-shaped thrombus of the tricuspid valve after VSD closure.

We report successful surgical management of a 26-year-old man with a ball-shaped thrombus of the tricuspid valve. He had been treated with prednisolone for IgA nephropathy and undergone surgical closure of an isolated ventricular septal defect (VSD). No symptoms, coagulative disorders, or pulmonary embolisms were found. Preoperative echocardiography showed a ball-shaped mass that had originated from the anterior leaflet of the tricuspid valve; it also revealed a small residual VSD. A histological examination revealed the mass to be an organized thrombus with no tumor components. This was a rare case of excision of an organized thrombus of the tricuspid valve. The findings suggest that the thrombus formation may have been associated with the small shunt and/or prednisolone. (Ann Thorac Cardiovasc Surg 2009; 15: 346–349)