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Ann Thorac Surg 1988;46:396-400
© 1988 The Society of Thoracic Surgeons

Articles

Surgical Removal of a Mobile, Pedunculated Left Ventricular Thrombus: Report of 4 Cases

Moshe Nili, M.D., Ehud Deviri, M.D., Ruth Jortner, M.D., Boris Strasberg, M.D., Morris J. Levy, M.D.*

Department of Cardiothoracic Surgery, Beilinson Medical Center, Petach Tikva, and Tel Aviv University Sadder School of Medicine, Tel Aviv, Israel

Accepted for publication March 31, 1988.

* Address reprint requests to Dr. Levy, Department of Cardiothoracic Surgery, Beilinson Medical Center, Petach Tikva 49100, Israel

During an 11-month period, 4 patients underwent surgical removal of a mobile, pedunculated left ventricular thrombus. All 4 patients had a history of myocardial infarction. Two of the 4 patients had systemic emboli, and in the 2 others, the ventricular thrombi were removed to prevent emboli. The thrombus was removed during the acute phase of myocardial infarction in 2 patients and one and two years, respectively, following the infarct in the remaining 2 patients. Concomitant coronary artery bypass grafting was performed in 3 patients. There were no early or late deaths, and none of the patients had clinical or echocardiographic evidence of recurrent thrombi or emboli at follow-up 3 to 15 months later. These results indicate that left ventricular thrombectomy might be an effective treatment for patients with mobile, pedunculated, left ventricular thrombi. However, additional experience is required to compare surgical and medical treatment.




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