Thrombotic occlusion of bilateral popliteal arteries by ball valve thrombus in left atrium.

We present a patient of mitral stenosis with a left atrial ball valve thrombus. The diagnosis was confirmed by transesophageal echocardiogram. No clot was detected in the left atrium or the left atrial appendage at surgery. At completion of surgery, the distal pulses of lower limbs were not palpable. Vascular Doppler study of lower limbs revealed thrombus-laden bilateral popliteal arteries. Emergency vascular surgery restored circulation in lower limb vessels.