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Updated: Apr 24, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
A treatment case of endoscopic removal of left ventricular thrombus, during coronary artery bypass graft
Hyun-Seok Park1, Se-Min Ryu1, Seong-Joon Cho1
1Department of Thoracic and Cardiovascular Surgery, Kangwon National University School of Medicine.
Insights
Left ventricular thrombus removal during thoracotomy can be dangerous. Using an endoscope offers a safer alternative for visualizing and manipulating the heart, potentially reducing fatal complications in acute myocardial infarction patients.
Area of Science:
- Cardiovascular Surgery
- Medical Endoscopy
- Cardiac Pathology
Background:
- Left ventricular thrombus is a frequent complication of acute myocardial infarction.
- Surgical removal via left ventricular incision carries risks of cardiac dysfunction, arrhythmias, and bleeding due to fragile myocardium.
Purpose of the Study:
- To evaluate the feasibility and benefits of using endoscopy for intraventricular manipulation in patients with left ventricular thrombus undergoing thoracotomy for other reasons.
- To reduce fatalities associated with traditional incision and suture techniques on infarcted cardiac tissue.
Main Methods:
- Endoscopic visualization and manipulation within the left ventricle.
- Application in patients requiring cardiopulmonary bypass and intracardiac manipulation.
Main Results:
- The study suggests that effective intraventricular visualization and manipulation can be achieved using an endoscope.
- This approach is considered beneficial in mitigating risks associated with traditional surgical methods.
Conclusions:
- Endoscopic intervention presents a potentially safer method for managing left ventricular thrombus in specific patient populations.
- This technique may decrease mortality and morbidity compared to open surgical approaches on infarcted myocardium.
Abstract:
Left ventricular thrombus is a common complication related to acute myocardial infarction. Removing this with an incision of the free wall of the left ventricle may cause fatal cardiac dysfunction or arrhythmias. Furthermore, performing incision and suture on the fragile myocardium of an acute myocardial infarction patient may cause serious bleeding complications. If there is a patient with left ventricular thrombus who needs thoracotomy for another reason, the case is attempted with the thought that if effective intraventricular visualization and manipulation can be done, fatalities caused by incision and suture may be reduced. For patients undergoing cardiopulmonary bypass, if intracardiac manipulation is required, an endoscope can be used, and given the potential complications after the incision and suturing of the infarcted tissue, the benefits are deemed sufficient.
