Key result
Transcatheter AngioVac via a retrograde transaortic approach successfully extracts LV thrombi.
Why the study?
Left ventricular thrombus is a clinically significant source of embolic complications in LV dysfunction, and transcatheter thrombectomy offers a viable alternative in high-risk surgical patients.
Case Report (n=1)
Transcatheter thrombectomy using a retrograde transaortic approach may be a viable alternative for high-surgical-risk patients with left ventricular thrombus.
Case success in high-risk LV thrombus is hypothesis-generating; leaves open need for prospective trials before adoption.
BACKGROUND: Left ventricular thrombus remains a clinically significant and under-recognized source of embolic complications in patients with left ventricular dysfunction. Transcatheter thrombectomy offers a viable alternative in high-risk surgical patients. CASE SUMMARY: A 64-year-old woman with history of anterior acute myocardial infarction presented as a code stroke given sudden-onset dysarthria and right-sided facial droop. Brain magnetic resonance imaging revealed several acute infarcts in the left middle cerebral artery territory, consistent with embolic phenomenon. Transthoracic echocardiography demonstrated mildly reduced left ventricular ejection fraction of 44%, apical akinesis, and the presence of multiple large mobile left ventricular thrombi adherent to a papillary muscle and chordal apparatus, the largest measuring 2.1 × 2.0 cm. Transcatheter left ventricular thrombectomy using the AngioVac system was pursued using a retrograde transaortic approach. TAKE-HOME MESSAGES: Transcatheter thrombectomy is a safe alternative for patients with left-sided intracardiac masses who are at high risk for surgery. Trans-septal or retrograde transaortic approaches may be used for mass extraction.
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Asselin et al. (2025) conducted a case report in Left ventricular thrombus (n=1). Transcatheter left ventricular thrombectomy using the AngioVac system was evaluated. Transcatheter left ventricular thrombectomy using the AngioVac system via a retrograde transaortic approach was utilized for mass extraction in a 64-year-old woman with left ventricular thrombi.
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