{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:44:23Z","timestamp":1785804263537,"version":"3.56.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Patients with rheumatic mitral stenosis (MS) often present complications such as atrial fibrillation and thrombus formation with significant morbi-mortality. Rarely, a free-floating \u2018ball thrombus\u2019 is found with possible catastrophic outcomes. We describe three cases of documented left atrial \u2018ping-pong\u2019 shaped \u2018thrombus ball\u2019 within MS: a 51\u00a0year old presented with acute heart failure with a fatal outcome due to the huge round thrombus closing the tight mitral valve, a 67-year-old and a 68-year-old male who were both urgently rushed to the operating room after accidental finding. The surgery was successful and consisted on mitral valve repair and thrombectomy. Our aim is to show that gigantic unattached thrombus ball within neglected rheumatism MS is a rare life-threatening entity, thus highlighting the importance of early diagnosis of such conditions present in endemic countries. A prompt surgery should be considered to avoid an eventual embolization and sudden death.<\/jats:p>","DOI":"10.1093\/jscr\/rjad266","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T18:33:18Z","timestamp":1684521198000},"source":"Crossref","is-referenced-by-count":3,"title":["Catastrophic outcomes of thrombus \u2018bumper\u2019 ball in neglected severe rheumatic mitral stenosis: report of three cases"],"prefix":"10.1093","volume":"2023","author":[{"given":"Zineb","family":"Agoumy","sequence":"first","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houda","family":"Bachri","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah E L","family":"Mhadi","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Chraibi","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zineb F","family":"Fehri","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamyaa","family":"Bakamel","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"El Assili","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoutar","family":"Berrag","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanae","family":"Es-sebany","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasna","family":"Leghlimi","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadwa","family":"Lachhab","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Tribak","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Bensouda","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Chaib","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesma","family":"Bendagha","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Soufiani","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Said","family":"Moughil","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Mohammed V University Cardiovascular Department B, , Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"2023051918330605600_ref1","first-page":"358","article-title":"Prevalence of left atrial thrombus in rheumatic mitral stenosis with atrial fibrillation and its response to anticoagulation: a transesophageal echocardiographic study","volume":"55","author":"Srimannarayana","year":"2003","journal-title":"Indian Heart 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