A Case of Myocardial Infarction with Both Ventricular Thrombi Undergoing Thrombectomy and Coronary Artery Bypass
- VernacularTitle:両心室内血栓を合併した心筋梗塞患者に対して血栓除去術・冠動脈バイパス術を施行した1例
- Author:
Erika HANJI
1
;
Muneyasu KAWASAKI
2
;
Tomoyuki KATAYANAGI
2
;
Keiichi TOKUHIRO
2
;
Takeshiro FUJII
1
Author Information
- Keywords: thrombus in both ventricles; rigid endoscope; thrombectomy
- From:Japanese Journal of Cardiovascular Surgery 2023;52(6):427-430
- CountryJapan
- Language:Japanese
- Abstract: A 48-year-old man was treated for heart failure at a nearby hospital, and echocardiography revealed thrombi in both ventricles. He was referred to our hospital for a detailed examination and treatment. Coronary angiography was performed, and the results were #2-3 50%, #5 50%, #6 100%, and #11 75%. Echocardiography revealed diffuse hypokinesis with an ejection fraction (EF) of 31%, which was indicative of old myocardial infarction. The left intraventricular thrombus was floating and adherent to the apex of the heart, and we judged that immediate surgical intervention was necessary to remove the thrombus and perform coronary artery bypass grafting. The right ventricular thrombus was removed through the tricuspid valve with an incision in the right atrium using a rigid endoscope to ensure that no thrombus remained behind. There were no perioperative embolic complications, and oral administration of direct oral anticoagulants (DOAC) was continued for one year after the operation. However, no recurrence of thrombosis was observed, and the prognosis was good.
