Floating thrombus in the left upper pulmonary vein dissolved by dabigatran

Abstract

Pulmonary vein thrombosis (PVT) is a rare but life-threatening condition. Although warfarin reduces the risk of atrial fibrillation (AF)-related stroke by 64%, the use of this drug has some limitations. Dabigatran is a relatively novel therapeutic option for patients with AF. The mechanism of action of dabigatran is unclear, and its ability to dissolve pulmonary vein thrombi is uncertain. Scans from a 64-slice multidetector CT (64-MDCT) scanner can evaluate coronary artery stenosis and detect left atrial appendage thrombi and pulmonary vein thrombi. A 73-year-old male patient presented with chest pain, and a 64-MDCT scan was performed to assess coronary artery stenosis. The 64-MDCT scan showed no stenosis but it did reveal a thrombus located in the centre of the left upper pulmonary vein. After 3 months of dabigatran therapy, the thrombus disappeared. This is the first case report of dabigatran dissolving a left upper pulmonary vein thrombus, as assessed by a 64-MDCT scan. Copyright 2013 BMJ Publishing Group. All rights reserved.