Key result
Careful hemodynamic management enables successful emergency laparotomy in concurrent LV and mesenteric thrombosis.
Why the study?
Left ventricular thrombus is a life-threatening complication after acute coronary syndromes associated with high morbidity and mortality, requiring careful perioperative management during emergency surgery.
Case Report (n=1)
No
This case report highlights the perioperative anesthetic management of a high-risk patient with severe ventricular dysfunction and left ventricular thrombus undergoing emergency abdominal surgery.
Supports careful hemodynamic management in rare LV thrombus cases undergoing emergency surgery; leaves open need for systematic evidence before broader adoption.
Left ventricular thrombus (LVT) is a life threatening complication following acute coronary syndromes but in modern era its incidence has reduced since the introduction of primary percutaneous intervention. LVT is associated with higher morbidity and mortality due to its thromboembolic events and major adverse cardiac events (MACE). This is a case report of 30-year-old male who presented with acute abdomen and left ventricular thrombus. CECT abdomen revealed superior mesenteric artery (SMA) thrombosis and echocardiography revealed severe ventricular dysfunction (ejection fraction, EF<30%) with global hypokinesia and LVT. SMA thrombosis is fatal and if left unattended can lead to intestinal ischemia and gangrene, hence immediate intervention is warranted. This patient had undergone emergency laparotomy under general anesthesia for the resection of gangrenous jejunal segment with mucous fistula . This case report discusses perioperative management considerations in such cases.
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Das Arpita (2025) conducted a case report in Left ventricular thrombus and superior mesenteric artery thrombosis (n=1). Emergency laparotomy under general anesthesia with perioperative anticoagulation was evaluated on Patient survival and postoperative recovery. A 30-year-old male with left ventricular thrombus and superior mesenteric artery thrombosis successfully underwent emergency laparotomy under general anesthesia with careful hemodynamic management.
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