[In-transit thrombi in right heart chambers treated with percutaneous intervention after COVID-19]

Acute and chronic complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are related to an acquired thromboinflammatory state. The incidence of deep vein thrombosis and acute pulmonary embolism in patients with COVID-19 is up to 85%, which is why thromboprophylaxis was recommended for hospitalized patients. In-transit thrombi increase mortality, so multiple management strategies have been developed. A 63-year-old man hospitalized for severe COVID-19 pneumonia was discharged after improvement. One month later, he presented to the emergency department with hemoptysis, dyspnea, and chest pain. A bulla was detected in the right lung as a complication of SARS-CoV-2 infection. It was treated with segmentectomy, and postoperatively, antithrombotic prophylaxis was administered. However, 24 hours later, the patient presented with ventilatory and hemodynamic deterioration, requiring invasive mechanical ventilation and vasopressor administration. Pulmonary embolism was found, so thrombectomy and in situ thrombolysis were performed, which significantly improved hemodynamic parameters. Percutaneous intervention in patients with COVID-19 who have a thrombus in transit is a therapeutic strategy that can improve outcomes and survival.