Large left atrial thrombus after mitral valve replacement: how to treat?

An 87-year-old lady, known to have permanent atrial fibrillation, underwent tissue mitral valve replacement at our institution. At the two-year follow-up, echocardiography revealed a large left atrial thrombus attached to the anterolateral wall and the mouth of the left atrial appendage remnant. The patient was treated with warfarin. One year later, the mass had fully resolved, thus avoiding the need for high-risk redo surgery.