Beating heart left ventricle thrombectomy through mini-left-anterior thoracotomy for a patient with cardiogenic shock.
Masato MutsugaAkihiko UsuiPublished in: General thoracic and cardiovascular surgery (2020)
Left ventricular (LV) thrombus is frequently occurred with dilated cardiomyopathy (DCM) when a patient receives extracorporeal membrane oxygenation (ECMO) support for cardiogenic shock. LV decompression techniques are sometimes required immediately after ECMO support. However, LV thrombus is a contra indication for LV assist device (LVAD). We planned a mini-left-anterior thoracotomy instead of using sternotomy, and used beating heart under ECMO support. LV was opened through apex and thrombectomy was performed by finger manipulation and the remained thrombus was removed by balloon guided technique. Our technique is a simple and durable method for removing LV thrombus under ECMO support and might be considered as a supplementary procedure before temporally LVAD.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- respiratory failure
- heart failure
- left ventricular
- aortic valve replacement
- mechanical ventilation
- case report
- acute ischemic stroke
- minimally invasive
- atrial fibrillation
- acute myocardial infarction
- left ventricular assist device
- transcatheter aortic valve implantation
- aortic valve
- acute coronary syndrome
- pulmonary arterial hypertension