Right Atrial Vacuum-Assisted Thrombectomy: Single-Center Experience

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Right heart thrombus without known cardiac conditions is rare and often indicates a thrombus-in-transit, posing a risk of pulmonary embolism.
• Optimal treatment for thrombi-in-transit remains debated, highlighting the need for effective therapeutic strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous vacuum aspiration for removing right heart thrombus.
• To assess the outcomes of using the AngioVac system for thrombectomy in hemodynamically stable patients.

Main Methods:

• A retrospective analysis of 7 hemodynamically stable patients who underwent vacuum thrombectomy using the AngioVac system between December 2012 and August 2014.
• Data collected included procedural success, complications, and follow-up outcomes for patients with right atrial mass.

Main Results:

• The procedure was successful in 6 out of 7 patients, with all patients surviving hospitalization.
• No major periprocedural complications such as bleeding, stroke, or myocardial infarction were observed.
• One patient required temporary extracorporeal membrane oxygenation support for cardiogenic shock; no recurrent venous thromboembolism occurred at 9-month follow-up.

Conclusions:

• Vacuum-assisted thrombectomy is a viable treatment option for large right-sided intracardiac thrombi in hemodynamically stable patients.
• This technique provides a potentially life-saving alternative for patients unsuitable for surgical intervention.