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.
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.
