Multiple calcified thrombi (rocks) in the right ventricle

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Radiology

Background:

• Recurrent pulmonary emboli can necessitate interventions like inferior vena cava ligation.
• Large, organized right ventricular thrombi are uncommon clinical findings.

Observation:

• A 51-year-old man presented with multiple mobile calcified thrombi in the right ventricle post-inferior vena cava ligation.
• An unusual two-component friction rub was noted, caused by calcified masses during cardiac cycles.
• Cardiac catheterization revealed a persistent constrictive-restrictive pattern.

Findings:

• Successful surgical resection of the right ventricular thrombi was achieved.
• The constrictive-restrictive pattern observed on cardiac catheterization persisted post-operatively.
• Noninvasive imaging played a crucial role in diagnosis and follow-up.

Implications:

• This case underscores the potential for rare complications following inferior vena cava ligation.
• It highlights the diagnostic utility of noninvasive studies for complex right ventricular thrombi.
• The persistent hemodynamic pattern suggests potential long-term sequelae requiring monitoring.