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Left ventricular thrombectomy in myocarditis: the epicardial scan & video-assisted transaortic approach.

Giuseppe GattiStefano PoliBernardo BenussiRossana BussaniAnnamaria IorioMarco ConfalonieriMarco MiloIrena TavcarAniello PappalardoGianfranco Sinagra
Published in: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy (2017)
In a 23-year-old man having myocarditis in the context of eosinophilic granulomatosis with polyangiitis, a mobile left ventricular apical thrombus was found with transthoracic echocardiography. Its surgical removal was established because there were no signs of resizing after effective intravascular anticoagulation therapy. Surgery was carried out via a median sternotomy with cardiopulmonary bypass. The site of endocardial implantation of the thrombus was identified with epicardial ultrasonography scan. The trans-aortic approach was adopted to avoid complications such as ventricular dysfunction and arrhythmias secondary to ventricular incision. Real-time imaging of the complete removal was obtained with optical instruments.
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