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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Rapid progression of left ventricular thrombus with left ventricular dysfunction detected by preoperative

Satoshi Kimura1, Masayoshi Umesue, Sho Matsuyama

  • 1Department of Cardiovascular Surgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|December 1, 2012
PubMed

Insights

A patient with ischemic cardiomyopathy and a rapidly progressive left ventricular (LV) thrombus underwent successful surgical treatment. Echocardiography is crucial for detecting LV thrombus before cardiac surgery in these patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Ischemic cardiomyopathy presents complex challenges in surgical planning.
  • Left ventricular (LV) thrombus formation is a known complication, increasing embolic risk.
  • The optimal timing and diagnostic approach for LV thrombus in this context require careful consideration.

Observation:

  • A patient initially scheduled for coronary artery bypass grafting (CABG) was found to have a significant left ventricular thrombus via preoperative echocardiography.
  • The thrombus was ball-like and previously undetected.
  • The patient underwent successful combined surgical revascularization and thrombectomy.

Findings:

  • Successful surgical management of a large, rapidly progressive left ventricular thrombus in a patient with ischemic cardiomyopathy.
  • Absence of systemic embolism during perioperative manipulation of the thrombus.
  • Demonstration of the feasibility of combined CABG and thrombectomy.

Implications:

  • Highlights the critical importance of thorough preoperative echocardiographic evaluation in patients with ischemic cardiomyopathy.
  • Suggests that prompt diagnosis and surgical intervention for LV thrombus can lead to favorable outcomes.
  • Emphasizes the role of transthoracic or transesophageal echocardiography in identifying potential embolic sources before cardiac procedures.

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