Malignancy-Induced Functional Tricuspid Obstruction Complicated by Cardiopulmonary Collapse Treated Using Combination...

Right-sided intracardiac masses, often arising from metastatic malignant diseases infiltrating the central venous system, may cause profound hemodynamic instability and life-threatening obstructive shock.

The authors present a case demonstrating the extent of both diagnostic and therapeutic utility of percutaneous large-bore vacuum-assisted aspiration thrombectomy in a patient presenting with intracardiac tumor-induced tricuspid valve obstruction and shock with subsequent cardiac arrest. Our patient was successfully resuscitated with venoarterial (VA) extracorporeal membrane oxygenation (ECMO) with a bridge to aspiration of the large intracardiac obstructing tumor by using a large-bore vacuum-assisted aspiration thrombectomy system.

This case demonstrates the successful use of large-bore aspiration thrombectomy in conjunction with VA ECMO to manage a patient presenting with a large intracardiac mass and obstructive shock. Large-bore vacuum-assisted aspiration thrombectomy facilitated both hemodynamic stabilization and rapid tissue diagnosis, which was crucial for guiding further management.

Although aggressive intervention in such cases may initially seem unorthodox, particularly in a patient with suspected metastatic disease, this case highlights its potential benefits when combined with a multidisciplinary approach and strong consideration of patient and family goals of care.