抗凝固療法中に形成された無症候性右房内球状血栓の1例

Asymptomatic Ball Thrombus in Right Atrium Under Anticoagulant Therapy：Report of a Case

はじめに　右房内血栓は，深部静脈血栓症や肺動脈塞栓症を伴う場合や，心房細動に続発する場合があるが，放置した場合の生命予後はわるく，すみやかな診断と治療を要する病態である1）．われわれは，抗凝固療法中にもかかわらず眼科術前のスクリーニング検査で指摘された右房内球状血栓に対し，外科的摘出術を施行し良好な転帰を得たので報告する．

A rare case of isolated right atrial thrombus under anticoagulant therapy for atrial fibrillation is reported herein. The patient was an 81-year-old man undergoing anticoagulant therapy with oral warfarin for atrial fibrillation. During preoperative screening for eye surgery, echocardiography revealed a mobile mass in the right atrium, and emergency hospital admission was indicated. Excision of the right atrial thrombus was performed, and no residual thrombus was detected on postoperative imaging studies. This case was considered a good indication for surgical resection because of potential risk of fatal embolism.