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Re: Large blood clot...any hope?
Posted By Richie on April 09, 1999 at 22:08:29:

In Reply to: Re: Large blood clot...any hope? posted by CCF CARDIO MD - DLB on April 04, 1999 at 16:17:47:

My father just had a serious stroke. A doppler test found a blood clot behind the heart measuring some 6 inches from which the clot that caused the stroke must likely broke off from. The surgery option was ruled out because the doctors believed the likelyhood that a piece (or pieces) would break off and cause a fatal stroke. They instead chose to use a number of blood thinners in an attempt to arrest the growth and dissolve the clot.
We understand that we're looking for a miracle here. The doctors have never even seen a clot of this size. My understanding of blood thinners is that they don't do anything to existing clots. Are there any that do?
Are we simply delaying the inevitable here? Any thoughts would be appreciated as we are realistic and understand what the likely outcome is.

                              Thank you, Richie

Dear Richie
Sometimes blood thinners are able to stabilize a clot and keep it from growing. Meanwhile, the body slowly dissolves what clot is already there with its own defense mechanisms. With time, the clot could get dissolved and whatever remains could become safely plastered to the heart walls. You are correct to be realistic, though, because his chance of a repeat stroke is high. Nonetheless, I have seen some patients in his situation do well with the blood thinners.
I hope this has been useful. Feel free to write back with further questions. Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.

I've recently gotten further news on my father's condition and would like to pass it by you. The 6 inch clot is actually caught in a "flap" INSIDE his heart.
Eventually, it will break off and likely kill him if it doesn't dissolve.
The thinners have stopped the growth at least but after a week the clot remains there. He's had a major stroke (can't eat, talk etc) on his right side.
Doctors have ruled out open heart surgery. They feel he would not survive it.
Either, the clot would break off anyway during surgery or the stroke area would bleed because of the procedure and he couldn't survive that. We're sitting back hoping for the clot to break and end up in a limb and be caught in time to save him. Obviously, that's a long shot but I'd just like to make sure this is the only option and would like to know if you concur with my doctor's opinion that open heart surgery in this case is not a viable option.

                          Thank you,    Richie
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