Robotic transmitral resection of floating left ventricular thrombus

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Robotic Surgery

Background:

• The role of surgery for left ventricular (LV) thrombi is debated.
• Robotic LV thrombectomy is an emerging treatment option.

Purpose of the Study:

• To present successful outcomes of robotic LV thrombectomy.
• To detail the operative technique for robotic mitral procedures.

Main Methods:

• Retrospective analysis of patients undergoing robotic LV thrombectomy using the da Vinci system.
• Review of serial echocardiograms and short- and long-term outcomes.
• Descriptive statistical analysis.

Main Results:

• Five patients (median age 46 years) with floating LV thrombi and embolization history underwent the procedure.
• Complete resection was achieved in all patients, with no postoperative deaths, strokes, or major complications.
• LV function improved post-surgery, with no recurrence or embolic events during a median 6-year follow-up.

Conclusions:

• Robotic LV thrombectomy demonstrates excellent outcomes and should be considered early for floating LV thrombi.
• Further research is needed to define optimal timing and broader application in mobile thrombus treatment.
• The study supports considering surgery for primary prevention of systemic embolization.