Figure 2:

(a), Cross section of thrombus protruding through a patent foramen ovale in the diseased heart at 20 μm/voxel. The characteristic ‘hourglass-shaped’ due to the lipomatous hypertrophy of the atrial septum (LHAS) can be observed. (b), Digital zoom centred on the thrombus better showing its heterogeneous structure, and showing extra-cardiac fat distending the inter-atrial groove between two thin layers of atrial myocardium (yellow stars). (c), 3D view of the thrombus after segmentation. The cylindrical shape and heterogeneous structure is consistent with an organising, pre-mortem deep vein thrombus, which has embolised into the oval fossa LA - left atrium; RA - right atrium; LHIAS - Lipomatous Hypertrophy of the Inter-Atrial Septum; Thr – Thrombus; OF - Oval Fossa; * - atrial myocardium