title: Right Atrial Vacuum-Assisted Thrombectomy: Single-Center Experience.
abstract: BACKGROUND
  Right heart thrombus in the absence of structural heart disease, atrial fibrillation, or intracardiac catheter is rare. It typically represents a thrombus migrating from the venous system to the lung, known as thrombi-in-transit, and can lead to a life-threatening pulmonary embolism. The optimal therapy for thrombi-in-transit remains controversial. We report our experience using percutaneous removal of right heart thrombus using vacuum aspiration.
  
  
  METHODS
  Patients with right atrial mass who were hemodynamically stable and underwent vacuum thombectomy using the AngioVac system (AngioDynamics) at our institution were included in this analysis. Between December 2012 and August 2014, a total of 7 patients (2 men, 5 women) with a mean age of 51.5 years (range, 20-83 years) underwent right atrial thrombectomy. Data during the procedure and follow-up period were collected and analyzed.
  
  
  RESULTS
  All patients were hemodynamically stable before the procedure. The procedure was considered successful in 6 patients. All patients survived through hospitalization. No periprocedural bleeding, stroke, or myocardial infarction occurred. One patient developed cardiogenic shock after the procedure that required extracorporeal membrane oxygenation support for <24 hours. There was no recurrent venous thromboembolism at a mean follow-up of 9 months.
  
  
  CONCLUSIONS
  Vacuum-assisted thrombectomy can be a potential treatment option for hemodynamically stable patients with large right-sided intracardiac thrombus who are not surgical candidates.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al Badri
authors.forename: Chad
authors.initials: C
authors.lastname: Kliger
authors.forename: Dillon
authors.initials: D
authors.lastname: Weiss
authors.forename: Luigi
authors.initials: L
authors.lastname: Pirelli
authors.forename: Sean
authors.initials: S
authors.lastname: Wilson
authors.forename: Edward R
authors.initials: ER
authors.lastname: DeLaney
authors.forename: Vladimir
authors.initials: V
authors.lastname: Jelnin
authors.forename: Itzhak
authors.initials: I
authors.lastname: Kronzon
authors.forename: Gila
authors.initials: G
authors.lastname: Perk
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Hemli
authors.forename: Nirav C
authors.initials: NC
authors.lastname: Patel
authors.forename: Suhail
authors.initials: S
authors.lastname: Raoof
authors.affiliation: Hackensack University Medical Center, 30 Prospect Avenue, 5 Main, Room 5640, Hackensack, NJ 07601 USA. cruizmd@gmail.com.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014618:Vacuum; D055815:Young Adult