title: [Left ventricular migrating thrombus detected by intraoperative transesophageal echocardiography].
abstract: Transesophageal echocardiography (TEE) helps detecting intra-cavity thrombus size, mobility and fragility, which are of great importance in surgical removal of the thrombus. Thrombus characteristics may render surgical thrombectomy incomplete, raising the risk of catastrophic embolization. A 50-year-old man, suffering from congestive heart failure, developed a mobile thrombus in the left ventricle (LV). He was scheduled for a LV thrombectomy. TEE showed two thrombi on the apical side of the left ventricle, measuring 2.1 x 1.3 cm and 2.1 x 1.0 cm each. A surgical removal of these thrombi was performed under cardiopulmonary bypass (CPB). Just before separation from CPB, TEE detected a high echogenic mass in the LV Surgical re-explorations found residual thrombi, whose size, figure and echo signal strength resembled papillary muscles. This experience leads us to advocate repeated search for thrombi using TEE scans, in order to facilitate complete removal of thrombi prior to closing the ventriculotomy, and prior to weaning from CPB.
authors.affiliation: Department of Anesthesiology, Shiga University of Medical Science, Otsu 520-2192.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yuasa
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Aoi
authors.forename: Takashi
authors.initials: T
authors.lastname: Chihara
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Imashuku
authors.forename: Shuichi
authors.initials: S
authors.lastname: Nosaka
mesh_terms: D017548:Echocardiography, Transesophageal; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D017131:Thrombectomy; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000601:surgery*