ABSTRACT
Mural thrombi probably develop on the left ventricular (LV) endocardial surface of all patients with transmural LV myocardial infarction (MI). The thrombi are nearly always attached over a broad surface, and protrusion into the LV cavity is limited. The authors recently studied a 54-year-old man who died 6 months after an acute MI and had an unusual LV thrombus. An aortogram disclosed total occlusion of the distal abdominal aorta, and the abdominal aorta and common iliac arteries were excised and replaced with a graft. The abdominal aorta and common iliac arteries were totally occluded by clot, presumably embolus from the left ventricle. Of over 500 patients studied by us at necropsy with either acute or healed MI, they have observed this type of elongated LV thrombus attached to a narrow base in only one previous patient, a 20-year-old man who had traumatic contusion of the LV wall.
