title: Trans-aortic endoscopic ventricular thrombectomy in a patient with HIT and concomitant Aortic and ventricular thromboses.
abstract: Dual aortic and ventricular thrombi are rare following myocardial infraction. We report the case of a 56-year-old man who initially denied primary percutaneous coronary intervention as a result of psychological phobia. Initial pharmacological management by thrombolysis and heparin was followed by multiple arterial thromboses including those of the left ventricle and right iliac artery with a subsequent diagnosis of heparin-induced thrombocytopaenia. Ensuing surgical management revealed the unanticipated finding of an additional aortic sinus thrombosis that was excised. The left ventricular thrombus was removed endoscopically to prevent ventricular incisions. This case emphasizes the technical advantages of video-endoscopic management of intracardiac thrombi and highlights the unexpected nature of multiple thromboses associated with heparin-induced thrombocytopaenia.
authors: Onassis Cardiac Surgery Centre, Athens, Greece.
authors: George T
authors: GT
authors: Stavridis
authors: Onassis Cardiac Surgery Centre, Athens, Greece.
authors: Maria
authors: M
authors: Vasili
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, Imperial College Healthcare NHS Trust at St Mary's Hospital, Praed Street, London, W2 1NY, UK. h.ashrafian@imperial.ac.uk.
authors: Hutan
authors: H
authors: Ashrafian
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, Imperial College Healthcare NHS Trust at St Mary's Hospital, Praed Street, London, W2 1NY, UK.
authors: Thanos
authors: T
authors: Athanasiou
authors: Onassis Cardiac Surgery Centre, Athens, Greece.
authors: Euthimia
authors: E
authors: Melissari
authors: Department of Cardiology, Mediterraneo Hospital, Glyfada, Greece.
authors: Athanasios
authors: A
authors: Manginas
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D004452:Echocardiography / Q000379:methods; D006331:Heart Diseases / Q000601:surgery*; D006352:Heart Ventricles; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012850:Sinus of Valsalva; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D013927:Thrombosis / Q000175:diagnosis / Q000601:surgery*
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Endoscopic; Heparin-induced thrombocytopaenia; Ventricular thrombectomy