Right Cardiac Thrombus in Transit Among Patients with Pulmonary Thromboemboli

Mollazadeh, Reza; Ostovan, Mohammad Ali; Ardekani, Ali Reza Abdi

doi:10.1002/clc.20386

Cited by 42 publications

(34 citation statements)

References 15 publications

(21 reference statements)

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“…PE, with an annual incidence of over 250,000 in the United States, presents as sudden death in up to 25% of cases . The presence of right heart thrombus is a predictor of hemodynamic decompensation, cardiac arrest and mortality . Patients with intracardiac mass, embolus in transit or PE with extensive iliocaval thrombus, particularly those who are poor candidates for thrombolytic therapy or surgical thromboembolectomy, may benefit from percutaneous mechanical thrombectomy.…”

Section: Introductionmentioning

confidence: 99%

Thrombectomy using suction filtration and veno‐venous bypass: Single center experience with a novel device

Donaldson

Baker

Narayan

et al. 2015

Cathet Cardio Intervent

115

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Section: Introductionmentioning

confidence: 99%

Thrombectomy using suction filtration and veno‐venous bypass: Single center experience with a novel device

Donaldson

Baker

Narayan

et al. 2015

Cathet Cardio Intervent

115

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“…Observational studies also report high early mortality rates, ranging from 29% to 50% [4, 9, 10]. More recent meta-analysis data suggest a slightly lower mortality rate of 16.7% [11].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Embolism and Intracardiac Type A Thrombus with an Unexpected Outcome

Português

Calvo

Oliveira

et al. 2017

Case Reports in Cardiology

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Detection of right heart thrombi (RHT) in the context of pulmonary thromboembolism (PE) is uncommon (4–18%) and increases the risk of mortality beyond the presence of PE alone. Type A thrombi are serpiginous and highly mobile and are thought to be originated from large veins and captured in-transit within the right heart. Optimal management of RHT is still uncertain. A 79-year-old woman, with a history of recent total hysterectomy with adnexectomy and a Wells procedure, presented to the emergency department following an episode of syncope. Computed tomography revealed bilateral PE and the presence of a right atrial thrombus. Transthoracic echocardiography demonstrated a free-floating type A thrombus in the right atrium, protruding into the right ventricle, and signs of pulmonary hypertension and right ventricle dysfunction. Considering the recent surgery and clinical stability, treatment with heparin alone was decided. Subsequent clinical improvement was observed and echocardiographic follow-up revealed complete thrombus dissolution and complete recovery of right ventricle function. Most authors recommend treatment of PE with RHT with thrombolysis or embolectomy followed by anticoagulation, although evidence is scarce. Individual risk of hemorrhage and operatory-related mortality should be taken into account when defining the treatment strategy especially when benefit is not firmly established.

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“…Mobile right heart thrombi essentially confirm the diagnosis of PE and their presence is associated with RV dysfunction and early mortality [2,4,5] as high as 21% in the first 24 h and an overall 45% in hospital mortality as reported in some studies [6]. Right heart mobile thrombi can be easily identified by 2-dimensional transthoracic or trans-esophageal echocardiography.…”

Section: Editorialmentioning

confidence: 91%