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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...

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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

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Transaortic Extraction of Left Ventricular Thrombus.

Joel Eyekpegha¹, Paul D Williams², Srinivasan V Krishnan³

¹Cardiothoracic Surgery, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom.

JACC. Case Reports

|August 8, 2025

Summary

Surgical thrombectomy for left ventricular thrombi can be beneficial in select acute myocardial infarction patients. A video-assisted transaortic approach offers excellent visualization and access, avoiding ventriculotomy complications.

Keywords:

anticoagulation coronary artery bypass thrombus

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Area of Science:

Cardiology
Cardiac Surgery
Interventional Cardiology

Background:

Left ventricular thrombi (LVT) are a complication of acute myocardial infarction (AMI).
Anticoagulation is the primary treatment for LVT.
Surgical thrombectomy is considered for high-risk patients with concurrent indications for cardiac surgery.

Observation:

A 43-year-old diabetic male presented with non-ST-segment elevation myocardial infarction and acute LVT.
The patient underwent a transaortic thrombectomy and coronary artery bypass graft.

Findings:

Traditional left ventriculotomy for thrombectomy can impair left ventricular function.
A video-assisted transaortic left ventriculoscopy provides superior visualization.
This technique avoids the need for ventriculotomy, mitigating functional decline.

Implications:

Video-assisted transaortic thrombectomy is a viable option for select AMI patients with LVT.
This approach enhances surgical safety and efficacy.
It offers improved visualization and access compared to conventional methods.