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Surgical Removal of Left Ventricular Thrombi Combined with Acute Myocarditis
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(Department of Cardiovascular Surgery, Hiroshima City Hospital, Hiroshima, Japan and Present address:Department of Cardiovascular Surgery, Okayama University Hospital*, Okayama, Japan and Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital**, Fukuyama, Japan)
| Noriyuki Tokunaga* |
Hideo Yoshida |
Kunikazu Hisamochi |
| Keiji Yunoki |
Daisuke Futagami** |
Hironori Ebishima* |
| Toshihiko Suzuki |
Hideyuki Kato |
Osamu Oba |
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A 47-year-old man had suffered from high grade fever and dyspnea for 10 days. He was transferred to our hospital in a condition of shock. Echocardiography showed severe diffuse hypokinesis of left ventricle (EF 21%), and multiple mobile thrombi in the left ventricle. Under a diagnosis of LV thrombi due to acute myocarditis, transatrial removal of LV thrombi was performed using video-assisted cardioscopy. He was weaned from cardiopulmonary bypass under IABP support. Postoperatively, he suffered from thromboembolism of the cerebral and right brachial artery. Thrombectomy of the right brachial artery and anticoagulation therapy was performed. IABP was removed on POD 3, and he no longer needed respiratory control on POD 4. Echocardiography on POD 6 showed marked improvement of the LV contractioniEF 52%). After rehabilitation, he was discharged on POD 23 on foot. Video-assisted cardioscopy allowed transatrial removal of LV thrombi, and preserved left ventricular function by avoiding ventriculotomy. Perioperative thromboembolism must be taken care of for a patient with multiple LV thrombi.
Jpn. J. Cardiovasc. Surg. 38:212-215i2009j
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