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[Totally Endoscopic Trans-atrial and Trans-mitral Removal of a Left Ventricular Thrombus through Right Minimally

Masanobu Sato1, Akitoshi Yamada, Sonoko Eizawa

  • 1Division of Cardiovascular Surgery, Kita-Harima Medical Center, Ono, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 7, 2026
PubMed

Insights

A minimally invasive endoscopic surgery successfully removed a large left ventricular thrombus in a myocardial infarction patient. This approach avoided left ventricular incision, proving safe and effective for selected cases.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Minimally Invasive Procedures

Background:

  • Acute myocardial infarction can lead to left ventricular thrombus formation.
  • Large or increasing left ventricular thrombi pose a significant risk of systemic embolism.
  • Traditional surgical approaches for thrombus removal may involve extensive cardiac exposure.

Purpose of the Study:

  • To evaluate the safety and efficacy of a totally endoscopic trans-atrial and trans-mitral approach for left ventricular thrombus removal.
  • To present a case of successful thrombus excision using a minimally invasive technique.

Main Methods:

  • A 49-year-old male patient with acute myocardial infarction and a growing left ventricular thrombus underwent surgery.
  • A totally endoscopic trans-atrial and trans-mitral approach was utilized via right minimally invasive thoracotomy.
  • Thrombus removal was performed under direct endoscopic visualization.

Main Results:

  • Complete removal of the left ventricular thrombus was achieved.
  • The procedure was performed without requiring a left ventricular incision.
  • The patient experienced an uneventful postoperative recovery with no residual thrombus detected on imaging.

Conclusions:

  • Totally endoscopic trans-atrial and trans-mitral surgery is a safe and effective option for selected patients with left ventricular thrombi.
  • Minimally invasive cardiac surgery can provide excellent outcomes for complex cardiac conditions.
  • Endoscopic visualization facilitates precise thrombus removal, minimizing cardiac trauma.

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