Surgical excision is a viable and successful treatment for mobile pedunculated left ventricular thrombi causing recurrent systemic embolization.
May support resection for select mobile LV thrombi with embolization; leaves open comparative efficacy versus anticoagulation.
A 51-year-old man was found to have left ventricular masses by transthoracic echocardiography, one attached to the posterior wall of the left ventricle and another attached to the anterolateral wall of the left ventricle. He had several events of systemic embolization over the last few weeks. Surgical excision was recommended to avoid further embolization. The patient underwent successful resection of the left ventricular masses under cardiopulmonary bypass through the left atrial and transverse aortotomy approach. Histopathologic exam was diagnostic for organized thrombi.
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Danesh et al. (2012) studied this question.
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