Case Report: Interatrial Thrombus in Left Atrial Septal Pouch Prohibiting Transseptal Puncture for Percutaneous Mitral Valve Therapy

Abstract An 82-year-old female patient with severe mitral regurgitation was referred for evaluation of percutaneous mitral valve repair. Transoesophageal echocardiography revealed a left atrial septal pouch (LASP) with an echogenic structure. Following the Heart team decision interventional therapy was therefore discarded. During surgery a thrombus in the LASP was found and carefully resected. Afterwards, conventional valve replacement with a biological 31mm-SJM-EPIC-prosthesis was performed. In the fast-evolving field of interventional mitral valve therapy a transseptal approach is the common strategy. Therefore, careful evaluation of the interatrial septum which may contain thrombi with transoesophageal echocardiography prior to intervention is of crucial importance.