Video-assisted transaortic left ventricular thrombectomy and coronary artery bypass grafting

Area of Science:

• Cardiology
• Cardiac Surgery
• Vascular Surgery

Background:

• Left ventricular thrombus formation is a serious complication following acute myocardial infarction (MI).
• Mobile thrombi pose a significant risk of systemic embolism, potentially leading to severe morbidity or mortality.
• Preserving cardiac function during intervention is crucial for patients with pre-existing cardiac dysfunction.

Observation:

• A 59-year-old male patient presented with left ventricular thrombi 10 days post-MI.
• Echocardiography identified two mobile thrombi, each approximately 2 cm in diameter.
• The patient had pre-existing cardiac dysfunction, necessitating a function-sparing surgical approach.

Findings:

• Urgent coronary artery bypass grafting (CABG) and video-assisted transaortic thrombectomy were performed.
• The thrombectomy was successfully achieved without a left ventricular incision, preserving cardiac function.
• Intraoperative endoscopy provided clear visualization of the left ventricular cavity and thrombi.

Implications:

• Minimally invasive transaortic thrombectomy is a viable option for managing left ventricular thrombi post-MI.
• Avoiding left ventricular incision can help preserve myocardial function in high-risk patients.
• Endoscopic visualization aids in complex intracardiac procedures, improving surgical outcomes.