case_images: PMC11694659_01
case_images: (A, B) Transoesophageal echocardiogram showed atrial septal defect (white arrow) with a large Chiari network with several sacculations (*) and originating in the inferior cava vein. (C) Transoesophageal echocardiogram, atrial septal defect with left-to-right shunt by Doppler colour. (D-F) Transoesophageal echocardiogram showed huge and mobile thrombus in the right atrium (white arrow), dependent on a membranous structure. (G, H) Cardiac-computed tomography with right atrial mass. (I) Macroscopic spherical thrombus was surgically removed.
case_images: ytae682f1.jpg
case_images: PMC11694659_01_ytae682f1.jpg
case_images: ytae682-F1
case_images: Transthoracic echocardiogram (TTE) showed an atrial septal defect (ASD) type ostium secundum of 17 x 18 mm, with a large Chiari network (CN) with several sacculations (Figure 1A-C). Transoesophageal echocardiogram confirmed the presence of a giant and hypermobile mass reliant on a thin membranous structure (Figure 1D-F, Supplementary material). CN, which had not been adequately removed. Chest computed tomography showed no evidence of pulmonary embolism and confirmed the thrombus (Figure 1G and H). Membrane remnants were resected, revealing a 20 x 20 mm spherical thrombus (Figure 1I), with no periprocedural embolic complications.