Abstract
Percutaneous retrieval of a 12-cm-long serpiginous clot lodged in the right atrium and ventricle is reported. Following bilateral common femoral vein puncture, a Bird’s Nest cava filter was first positioned ready to deploy immediately below the renal veins via the right femoral vein. From the left femoral vein, a Cook intravascular retrieval basket was advanced to the right atrium. Under transthoracic echocardiographic visualization, the basket was used to engage, trap, and gently withdraw the clot in a single long strand below the prepositioned inferior vena cava filter. The filter was immediately deployed, leaving the clot trapped inferior to the renal veins, in the cava and left iliac vein. The patient remained well and asymptomatic at discharge.
Similar content being viewed by others
References
Chapoutot L, Nazeyrollas P, Metz D, Maes D, Maillier B, Jennesseaux C, Elaerts J (1996) Floating right heart thrombi and pulmonary embolism: Diagnosis, outcome and therapeutic management. Cardiology 87:169–174
Chapoutot L, Tassigny C, Nazeyrollas P, Poismans P, Mallier B, Maes D, Metz D, Elaerts J (1995) Pulmonary embolism and thrombi of the right heart. Arch Mal Couer Vaiss 88[Suppl 11]:1723–1728
Janata-Schwatczek K, Weiss K, Riezinger I, Bankier A, Domanovitis H, Seidler D (1996) Pulmonary embolism. II. Diagnosis and treatment. Semin Thromb Hemost 22(1):33–52
Dismuke SE, Wagner EH (1986) Pulmonary embolism as a cause of death: The changing mortality in hospitalized patients. JAMA 225:2039–2042
Willens HJ, Ciraldo R, Vuoto T, Kessler KM (1995) Combined pulmonary embolectomy and right atrial thromboembolectomy guided by transesophageal echocardiography. Am Heart J 130:180–182
Heinrich F (1993) Clinical aspects, diagnosis and therapy of pulmonary embolism. Z Gesamte Inn Med 48(11):518–524
Chapoutot L, Metz D, Canivet E, Maillier B, Torossian F, Pommier JL, Nazeyrollas P, Sal R, Baehrel B Elaerts J (1993) Mobile thrombus of the right heart and pulmonary embolism: Diagnostic and therapeutic problems. Apropos of 12 cases. Arch Mal Coeur Vaiss 86(7):1039–1045
Lau YS, Chee TS, Chua KL (1994) Echocardiographic detection of mobile right atrial thrombus. Singapore Med J 35(1):112–114
Markel A, Manzo RA, Strandness DE (1992) The potential role of thrombolytic therapy in venous thrombosis. Arch Intern Med 152:1265–1267
PIOPED (1990) Tissue plasminogen activator for the treatment of acute pulmonary embolism. Chest 97:528–533
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Davies, R.P., Harding, J. & Hassam, R. Percutaneous retrieval of a right atrioventricular embolus. Cardiovasc Intervent Radiol 21, 433–435 (1998). https://doi.org/10.1007/s002709900295
Issue Date:
DOI: https://doi.org/10.1007/s002709900295