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Updated: Dec 5, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Beating heart left ventricle thrombectomy through mini-left-anterior thoracotomy for a patient with cardiogenic shock
Masato Mutsuga1, Akihiko Usui2
1Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan. mutsuga@med.nagoya-u.ac.jp.
Abstract:
Left ventricular (LV) thrombus is frequently occurred with dilated cardiomyopathy (DCM) when a patient receives extracorporeal membrane oxygenation (ECMO) support for cardiogenic shock. LV decompression techniques are sometimes required immediately after ECMO support. However, LV thrombus is a contra indication for LV assist device (LVAD). We planned a mini-left-anterior thoracotomy instead of using sternotomy, and used beating heart under ECMO support. LV was opened through apex and thrombectomy was performed by finger manipulation and the remained thrombus was removed by balloon guided technique. Our technique is a simple and durable method for removing LV thrombus under ECMO support and might be considered as a supplementary procedure before temporally LVAD.
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