Reply to Zisis

Abstract

We thank you Dr Zisis [1] for the comment on our article [2]. We reported a woman with rheumatic heart disease and atrial fibrillation. Computed tomography angiography (CTA) revealed a thrombus in the left atrium, occlusion in the infrarenal aorta and efficient development of collateral circulation of the epigastric arteries. Fig. 2 shows the occlusion suspected to be of embolic origin in the infrarenal aorta because we could not accurately diagnose whether it was aorto-iliac occlusive disease (Leriche syndrome) with significant collateralization or results from cardiac thrombus. However, the development of such a bypassing collateral vascular network obviously indicates it was not an acute aortic occlusion (AAO). The patient did not have a previous peripheral arterial reconstruction and atherosclerotic cardiac disease but suffered from rheumatic heart disease. Severe mitral valve