Selective Right Atrial Thrombectomy for Clot-in-Transit With Dynamic Tricuspid Inflow Obstruction Complicating Acute Pulmonary Embolism

Key Result

Selective right atrial aspiration thrombectomy successfully removed a 15-cm thrombus, resulting in immediate hemodynamic improvement in a patient with acute pulmonary embolism and shock.

Key Points

• Evaluate the efficacy of selective right atrial thrombectomy for patients with clot-in-transit complicating pulmonary embolism.
• A 96-year-old woman presented with recurrent syncope, hypoxia, and shock due to acute pulmonary embolism.
• Imaging confirmed right atrial clot-in-transit, necessitating selective aspiration thrombectomy, as systemic thrombolysis was contraindicated.
• Thrombectomy removed a 15-cm thrombus, leading to assessment of hemodynamic improvement.
• Immediate hemodynamic improvement was observed post-thrombectomy.
• Dynamic tricuspid inflow obstruction was identified as a contributing factor to shock in the patient.
• Thrombectomy effectively restored cardiac function in the context of acute pulmonary embolism.