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Published on: August 16, 2021
Percutaneous Thrombectomy for Clot-in-Transit With Concomitant Left Ventricular Thrombus in a Patient With Acute
Ebram Eskandar1, Sachin Joseph1, Andres Vargas Estrada2
1Internal Medicine, Florida State University, Tallahassee, USA.
None:
Clot-in-transit (CIT) is a life-threatening condition in which a venous thrombus is visualized within the right heart while migrating toward the pulmonary arteries. Its coexistence with severe cardiomyopathy and a left ventricular thrombus confers high morbidity and mortality. We report the case of a woman in her 40s with advanced heart failure with reduced ejection fraction (HFrEF), with a left ventricular ejection fraction (LVEF) of 10%-15%, who presented with acute pulmonary embolism (PE) , a large mobile thrombus traversing the tricuspid valve, and an apical left ventricular thrombus, complicated by cardiogenic shock. Given her hemodynamic instability and high surgical risk, she underwent emergent percutaneous aspiration thrombectomy using the FlowTriever device (Inari Medical, Inc., Irvine, CA), achieving successful clot removal and hemodynamic improvement. This case highlights the role of minimally invasive thrombectomy in selected high-risk patients.
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