Key result
TEE successfully guides diagnosis and surgical removal of LV thrombus in an LVAD patient.
Why the study?
Left ventricular thrombus diagnosis and treatment in patients with LVAD after acute myocardial infarction is challenging and requires effective imaging guidance.
Case Report (n=1)
No
Successful TEE-guided LV thrombus management in LVAD patient; leaves open generalizability and need for prospective validation.
This paper reports the successful treatment of a left ventricular thrombus detected and treated using transesophageal echocardiography (TEE) in an acute myocardial patient implanted with a left ventricular assist device (LVAD).The patient underwent LVAD implantion because of severe left heart failure after coronary artery bypass grafting and anticoagulant therapy was performed by heparin administration via an indwelling catheter in the left ventricle space. On 4th day after implantation, a mobile, pedunculated, protruding left ventricular thrombus was detected by TEE, and subsequent thrombolytic therapy with urokinase infusion failed. Thus, on the 6th day surgical removal was attempted. During surgery, the thrombus was removed using a wall-sucker under TEE guidance.We conclude that TEE is useful not only in the diagnosis of left ventricular thrombus, but also in its treatment.
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Shimaoka et al. (1995) conducted a case report in Left Ventricular Thrombus (n=1). Transesophageal echocardiography-guided surgical thrombus removal was evaluated on Successful diagnosis and removal of left ventricular thrombus. Transesophageal echocardiography successfully guided the diagnosis and surgical removal of a left ventricular thrombus in an acute myocardial infarction patient implanted with a left ventricular assist device.
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