Transcatheter Left Ventricular Thrombectomy in a Critically Ill Child Using a Novel Retrieval Device

Left ventricular (LV) thrombectomy is a high-risk procedure, but when anticoagulation fails, it may be an important treatment option to prevent a catastrophic outcome.

A 13-year-old boy with congenitally corrected transposition of the great arteries developed an LV thrombus after heart transplantation despite systemic anticoagulation. Given ongoing cerebrovascular events, we elected thrombus removal via transcatheter snare thrombectomy assisted by the ONO retrieval device.

There is limited evidence on the management of LV thrombectomy if anticoagulation fails. Newer catheter techniques and equipment can allow operators to perform this technique safely with adequate embolic protection in select pediatric patients with suitable arterial vascular access. Collaboration with imaging colleagues is key to success.

Alternative access sites, novel device use, and collaboration and learning from colleagues can expand the repertoire of congenital interventionalists to treat high-risk and rare conditions.