Successful echocardiography-guided indirect right atrial thrombectomy in a pregnant patient: a case report

Floating thrombus in right heart indicates a high probability of pulmonary embolism, which can lead to severe consequences, including sudden death. Floating right heart thrombi in pregnant women are a rare but potentially dangerous complication that requires immediate treatment. The management of such patients requires an individual multidisciplinary approach taking into account the patient’s condition and thrombus characteristics. This article presents a case of successful thrombectomy in a 26-year-old patient in the second trimester of her second pregnancy with floating right atrial thrombosis. This case is unique due to the combination of following risk factors for thrombosis: pregnancy, genetic thrombophilia, and prior chronic thromboembolic pulmonary hypertension with pulmonary endarterectomy. A special feature of this case is successful indirect transjugular thrombectomy with echocardiography guidance as a less invasive alternative to open surgery or angiography-guided endovascular intervention, which minimized the risks of complications and achieved a favorable outcome. However, adherence to the proper interbirth interval and optimal anticoagulant prophylaxis in pregnancy would reduce the risks of thromboembolic events.