title: Surgical removal of a large mobile left ventricular thrombus via left atriotomy.
abstract: Left ventricular (LV) thrombus is a life-threatening complication of severe LV dysfunction. Ventriculotomy has been a commonly performed procedure for LV thrombus; however, it often further decrease LV function after surgery. We present an alternative approach to thrombectomy in order to minimize the postoperative LV dysfunction. A 37-year-old female with a postpartum cardiomyopathy found to have poor LV function and a large left ventricular apical thrombus (3 cm × 3 cm) attached to the apex by a narrow stalk. Given her severe LV dysfunction, the LV thrombus was approached via left atriotomy under cardiopulmonary bypass. The LV thrombus was easily extracted with gentle traction via the mitral valve. Postoperatively, the patient was discharged home without any embolization event or inotropic support. LV thrombectomy via left atriotomy through the mitral valve could be an alternative option for the patients with poor LV function with a mobile LV thrombus.
authors.affiliation: Daizo Tanaka, Shinya Unai, James T Diehl, Hitoshi Hirose, Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, United States.
authors.forename: Daizo
authors.initials: D
authors.lastname: Tanaka
authors.affiliation: Daizo Tanaka, Shinya Unai, James T Diehl, Hitoshi Hirose, Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, United States.
authors.forename: Shinya
authors.initials: S
authors.lastname: Unai
authors.affiliation: Daizo Tanaka, Shinya Unai, James T Diehl, Hitoshi Hirose, Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, United States.
authors.forename: James T
authors.initials: JT
authors.lastname: Diehl
authors.affiliation: Daizo Tanaka, Shinya Unai, James T Diehl, Hitoshi Hirose, Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, United States.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirose
keywords: Atriotomy; Cardiomyopathy; Left ventricular thrombus; Pedunculated thrombus; Surgical thrombectomy