Thrombus Migration Resulting From Cessation of Cardiopulmonary Bypass Flow in a Patient With Left Ventricular Thrombus

Figures

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  Figure 1. Two-dimensional TTE (day 13), parasternal short-axis view at the apical level, demonstrates an intraventricular thrombus attached to the left ventricular wall (arrow). LV, Left ventricle.

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  Figure 2. Contrast-enhanced computed tomographic images (day 13), multiplanar reformat in (A) coronal, (B) sagittal, and (C) axial displays, demonstrate a LV apical thrombus (arrows).

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  Figure 3. Two-dimensional transesophageal echocardiography (day 16, before CPB), midesophageal, left ventricular–focused modified two-chamber (72°) diastolic (left) and systolic (right) displays, demonstrates an intraventricular thrombus attached to the left ventricular apical wall (arrow). LV, Left ventricle.

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  Figure 4. Two-dimensional epicardial echocardiography (day 16, after CPB initiation), left ventricular long-axis diastolic (left) and systolic (right) displays, demonstrates a thrombus (arrows) dislodged into the LVOT. The anterior echo-free space represents the placement of a fluid-filled bag (asterisk) between the echocardiographic probe and the heart to allow optimal imaging. Ao, Aorta; LV, left ventricle.

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  Figure 5. Angiographic images during emergency endovascular thrombectomy demonstrate (A) total occlusion in the anterior tibial, posterior tibial, and fibular arteries from the embolized thrombus with restoration of arterial flow (B) after endovascular thrombectomy.

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  Figure 6. Timeline demonstrates the clinical presentation, management, laboratory results, detection of LV thrombus, stroke event, and surgical intervention during the prolonged hospital course. PCI, Percutaneous coronary intervention.