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Dramatic improvement of LV function after coronary sinus thromboembolectomy
1Thoracic and Cardiovascular Department, University Hospital, Siena, Italy. euxneri@tin.it
Insights
A 79-year-old man with atrial fibrillation experienced improved cardiac function after surgery for coronary sinus and atrial thrombosis. This suggests the cardiac venous system is crucial for myocardial impairment.
Area of Science:
- Cardiology
- Vascular Medicine
- Cardiac Surgery
Background:
- Chronic atrial fibrillation and severe left ventricular dysfunction are significant cardiovascular conditions.
- Pulmonary hypertension can complicate cardiac conditions, impacting patient outcomes.
- Thrombosis within the cardiac venous system is a rare but serious complication.
Observation:
- A 79-year-old male patient presented with multiple cardiovascular issues, including atrial fibrillation and impaired left ventricular function.
- Incidental discovery of complete coronary sinus thrombosis during preoperative screening.
- Massive right atrial thrombosis and pulmonary hypertension were also noted.
Findings:
- Successful surgical embolectomy of the coronary sinus, right atrium, and pulmonary artery was performed.
- The patient exhibited a dramatic improvement in cardiac performance post-operatively.
- Significant recovery of left ventricular function was observed, highlighting the impact of venous intervention.
Implications:
- The cardiac venous system's role in myocardial impairment is underscored by this case.
- Interventions targeting cardiac venous thrombosis can lead to substantial recovery of cardiac function.
- This case highlights the importance of considering venous thrombosis in complex cardiac presentations.
Abstract:
We present the case of a 79-year-old man suffering from chronic atrial fibrillation, severe left ventricular dysfunction, massive right atrial thrombosis, and pulmonary hypertension. Complete coronary sinus thrombosis was found incidentally during preoperative screening. Successful coronary sinus, right atrial, and pulmonary operative embolectomy was followed soon after by a dramatic improvement of cardiac performance; the patient's left ventricular function recovery, in particular, suggests that cardiac venous system played an important role in the genesis of myocardial impairment.