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Complicated Massive Left Ventricular Thrombus and Surgical Treatment

Patient: Female, 74-year-old Final Diagnosis: Thrombosis Symptoms: Dyspnea Medication:— Clinical Procedure: — Specialty: Cardiac Surgery OBJECTIVE: Rare disease BACKGROUND: Left ventricular thrombus formation is a serious complication of cardiac diseases and may result in acute embolic events. Early...

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Autores principales: Pasli, Sedat, Kamler, Markus, Malik, Rizwan, Easo, Jerry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549525/
https://www.ncbi.nlm.nih.gov/pubmed/36193014
http://dx.doi.org/10.12659/AJCR.937341
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author Pasli, Sedat
Kamler, Markus
Malik, Rizwan
Easo, Jerry
author_facet Pasli, Sedat
Kamler, Markus
Malik, Rizwan
Easo, Jerry
author_sort Pasli, Sedat
collection PubMed
description Patient: Female, 74-year-old Final Diagnosis: Thrombosis Symptoms: Dyspnea Medication:— Clinical Procedure: — Specialty: Cardiac Surgery OBJECTIVE: Rare disease BACKGROUND: Left ventricular thrombus formation is a serious complication of cardiac diseases and may result in acute embolic events. Early diagnosis and prompt treatment are crucial steps in preventing complications. There is a lack of consensus when it comes to therapy recommendations such as treatment with anticoagulation, thrombolysis, or surgical thrombectomy. CASE REPORT: A 74-year-old woman presented with acute peripheral ischemia in the left and right lower limbs. After running a diagnostic workup, we found a history of fatigue and dyspnea in the preceding 2 weeks; and an echocardiographic examination revealed a large floating mass in the left ventricle with a severely reduced LV ejection fraction of 10-15%. Coronary heart disease was diagnosed with stenosis of the circumflex artery and posterior branch of the right coronary artery, but not necessitating acute treatment. The decision to operate on our patient was based on the acute situation and mobile form of the thrombi as to prevent further thromboembolic complications, and the surgical procedure was performed via a median sternotomy using a left ventricular apical approach due to the size and deep embedment in the ventricular trabeculae. CONCLUSIONS: To date there is no standardized therapy in the guidelines for treatment of LV thrombi. Surgical thrombectomy can be performed in patients with mobile and protruding thrombi. In such cases surgery should be performed immediately due to the high risk of systemic embolism.
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spelling pubmed-95495252022-10-25 Complicated Massive Left Ventricular Thrombus and Surgical Treatment Pasli, Sedat Kamler, Markus Malik, Rizwan Easo, Jerry Am J Case Rep Articles Patient: Female, 74-year-old Final Diagnosis: Thrombosis Symptoms: Dyspnea Medication:— Clinical Procedure: — Specialty: Cardiac Surgery OBJECTIVE: Rare disease BACKGROUND: Left ventricular thrombus formation is a serious complication of cardiac diseases and may result in acute embolic events. Early diagnosis and prompt treatment are crucial steps in preventing complications. There is a lack of consensus when it comes to therapy recommendations such as treatment with anticoagulation, thrombolysis, or surgical thrombectomy. CASE REPORT: A 74-year-old woman presented with acute peripheral ischemia in the left and right lower limbs. After running a diagnostic workup, we found a history of fatigue and dyspnea in the preceding 2 weeks; and an echocardiographic examination revealed a large floating mass in the left ventricle with a severely reduced LV ejection fraction of 10-15%. Coronary heart disease was diagnosed with stenosis of the circumflex artery and posterior branch of the right coronary artery, but not necessitating acute treatment. The decision to operate on our patient was based on the acute situation and mobile form of the thrombi as to prevent further thromboembolic complications, and the surgical procedure was performed via a median sternotomy using a left ventricular apical approach due to the size and deep embedment in the ventricular trabeculae. CONCLUSIONS: To date there is no standardized therapy in the guidelines for treatment of LV thrombi. Surgical thrombectomy can be performed in patients with mobile and protruding thrombi. In such cases surgery should be performed immediately due to the high risk of systemic embolism. International Scientific Literature, Inc. 2022-10-04 /pmc/articles/PMC9549525/ /pubmed/36193014 http://dx.doi.org/10.12659/AJCR.937341 Text en © Am J Case Rep, 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Pasli, Sedat
Kamler, Markus
Malik, Rizwan
Easo, Jerry
Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title_full Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title_fullStr Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title_full_unstemmed Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title_short Complicated Massive Left Ventricular Thrombus and Surgical Treatment
title_sort complicated massive left ventricular thrombus and surgical treatment
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549525/
https://www.ncbi.nlm.nih.gov/pubmed/36193014
http://dx.doi.org/10.12659/AJCR.937341
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