title: Unrecognized left ventricular thrombus during reoperative coronary artery bypass grafting.
abstract: Left ventricular thrombus after myocardial infarction is relatively common but rarely threatening enough to warrant surgical removal at the time of coronary revascularization. The rare cases of ventricular thrombectomy described in the literature involve a pedunculated thrombus. We describe an urgent coronary revascularization procedure in a patient who had unrecognized left ventricular thrombus. The large clot was detected by transesophageal echocardiography after decannulation in a hemodynamically unstable patient. The thrombus was removed after placing the patient back on cardiopulmonary bypass emergently. He recovered and was discharged with no neurologic sequelae. Aggressive removal of clot using cardiopulmonary bypass is warranted even for the critically ill patient.
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Afshin
authors.initials: A
authors.lastname: Ehsan
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Couper
authors.forename: Stanton K
authors.initials: SK
authors.lastname: Shernan
authors.forename: Richard M
authors.initials: RM
authors.lastname: Wholey
authors.forename: Sary F
authors.initials: SF
authors.lastname: Aranki
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D017548:Echocardiography, Transesophageal; D004630:Emergencies; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D033162:Incidental Findings; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery*; D010138:Pacemaker, Artificial; D012008:Recurrence; D012804:Sick Sinus Syndrome / Q000150:complications / Q000628:therapy; D017131:Thrombectomy; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D002316:Cardiotonic Agents