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[Left Ventricular Thrombectomy in Patients with Dilated Cardiomyopathy Accompanied by Cerebral Embolism:Report of Two

Hitomi Naruse1, Shingo Taguchi, Kei Tanaka

  • 1Department of Cardiac Surgery, Fuji City General Hospital, Fuji, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 2021
PubMed

Insights

Left ventricular thrombus (LVT) can occur in dilated cardiomyopathy (DCM). Even without prior clots, DCM patients with low ejection fraction and enlarged ventricles need anticoagulation and monitoring to prevent stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Left ventricular thrombus (LVT) is a recognized complication of ischemic heart disease.
  • Dilated cardiomyopathy (DCM) is a less common cause of LVT compared to other conditions like myocardial infarction.

Observation:

  • Two patients with DCM and LVT experienced acute cerebral infarction.
  • Both patients had sinus rhythm and no prior thromboembolic events.
  • Transthoracic echocardiography revealed LVT indicators: ejection fraction <35% and diastolic diameter ≥60 mm.

Findings:

  • DCM patients with specific echocardiographic findings are at high risk for LVT.
  • Anticoagulation and regular imaging are crucial for DCM patients, irrespective of sinus rhythm or thromboembolic history.

Implications:

  • Early detection and management of LVT in DCM are vital to prevent devastating embolic events.
  • Thrombectomy is a critical intervention for acute cerebral infarction secondary to LVT in DCM patients.

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