An intraoperative transesophageal echocardiography-guided maneuver to assist the removal of an intraventricular thrombus

Intra-cavitary thrombus size, mobility and friability are of great importance in deciding whether surgical removal is indicated. Thrombus characteristics may render surgical thrombectomy incomplete, a risk for catastrophic embolization. During de-airing of the heart, after removal of an intraventric...

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Bibliographic Details
Main Author: Gologorsky,Edward (author)
Other Authors: Carvalho,Enisa M (author), Macedo,Francisco Igor (author), Salerno,Tomas (author)
Format: report
Language:eng
Published: 2009
Subjects:
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382009000500022
Country:Brazil
Oai:oai:scielo:S0102-76382009000500022
Description
Summary:Intra-cavitary thrombus size, mobility and friability are of great importance in deciding whether surgical removal is indicated. Thrombus characteristics may render surgical thrombectomy incomplete, a risk for catastrophic embolization. During de-airing of the heart, after removal of an intraventricular thrombus, filling the open ventricular cavity with blood serendipitously allowed trans-esophageal echocardiographic (TEE) visualization of undetected residual thrombi fragments. This experience leads us to advocate repeated filling and emptying of the left ventricle with blood, under TEE guidance, in order to facilitate complete removal of thrombotic material prior to ventriculotomy closure, and prior to weaning from cardiopulmonary bypass (CPB).