Key result
Trans-IVC Poole suction successfully resolves intraoperative right atrial thrombus and cardiovascular collapse during liver transplant.
Why the study?
Intracardiac thrombus during orthotopic liver transplant is associated with high mortality, with unclear pathophysiology and no consensus treatment guidelines.
Case Report (n=1)
May offer a rescue option for right atrial thrombus collapse in liver transplant; leaves open generalizability and safety.
Intracardiac thrombus occurs in 1.2%-6.3% of patients undergoing orthotopic liver transplant and is associated with a high mortality rate. The pathophysiology and risk factors for development of this complication are not well understood. No consensus treatment guidelines exist, and specific therapies are associated with serious risks. We present the timely and successful use of a Poole tip surgical suction device advanced into the right atrium through a cavotomy created in the inferior vena cava to remove a large right atrial thrombus during liver transplant. The thrombus was identified with transesophageal echocardiography and was causing cardiovascular collapse.
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Vogt et al. (2017) conducted a case report in Intracardiac thrombus with cardiovascular collapse during liver transplant (n=1). Poole tip surgical suction device advanced through a cavotomy in the inferior vena cava was evaluated on Removal of right atrial thrombus and resolution of cardiovascular collapse. Removal of a large right atrial thrombus causing cardiovascular collapse during liver transplant was successfully achieved using a Poole tip suction device advanced through the inferior vena cava.
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