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Surgical Extirpation of Apical Left Ventricular Thrombus in Takotsubo Cardiomyopathy

Tetsuya Niino1, Satoshi Unosawa1

  • 1Department of Cardiovascular Surgery, National Hospital Organization Disaster Medical Center, Japan.

Case Reports in Surgery
|June 24, 2015
PubMed

Insights

This case study details a patient with takotsubo cardiomyopathy who developed a left ventricular thrombus. Surgical removal of the apical thrombus led to an uneventful recovery.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Takotsubo cardiomyopathy (TTC) is a form of non-ischemic cardiomyopathy often presenting with symptoms mimicking acute myocardial infarction.
  • Left ventricular thrombus formation is a recognized complication of TTC, posing a risk of systemic thromboembolism.

Purpose of the Study:

  • To report a case of takotsubo cardiomyopathy with apical left ventricular thrombus requiring surgical intervention.
  • To highlight the successful surgical resection of a left ventricular thrombus in a patient with TTC.

Main Methods:

  • Diagnosis of TTC was based on clinical presentation, electrocardiogram, echocardiography, and normal coronary angiography.
  • Echocardiography identified a mobile apical left ventricular thrombus.
  • Surgical thrombectomy was performed via a left apical incision.

Main Results:

  • The patient presented with shock, hypothermia, and diabetic ketoacidosis, initially showing ST-segment elevation and reduced ejection fraction with apical akinesis.
  • Coronary angiography revealed normal coronary arteries, confirming the diagnosis of TTC.
  • Postoperative recovery following surgical thrombus resection was uneventful, with improved ejection fraction noted on follow-up echocardiography.

Conclusions:

  • Surgical resection of apical left ventricular thrombus is a viable treatment option in selected patients with takotsubo cardiomyopathy.
  • Prompt diagnosis and management of complications like left ventricular thrombus are crucial for favorable outcomes in TTC.

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