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Beating heart left ventricle thrombectomy through mini-left-anterior thoracotomy for a patient with cardiogenic shock

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Abstract

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.

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Authors and Affiliations

  1. Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan

    Masato Mutsuga & Akihiko Usui

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  1. Masato Mutsuga
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  2. Akihiko Usui
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Correspondence to Masato Mutsuga.

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The details of the operative procedure were described in surgical technique (MP4 137144 kb)

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Mutsuga, M., Usui, A. Beating heart left ventricle thrombectomy through mini-left-anterior thoracotomy for a patient with cardiogenic shock. Gen Thorac Cardiovasc Surg 69, 614–617 (2021). https://doi.org/10.1007/s11748-020-01510-3

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  • DOI: https://doi.org/10.1007/s11748-020-01510-3

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