Video-assisted transaortic left ventricular thrombectomy and coronary artery bypass grafting

Kikuchi, Chizuo; Shimada, Keizo; Nakayama, Kenji; Ohzeki, Hajime

doi:10.1007/s11748-008-0357-1

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…Endoscopy has also been used for LV thrombectomy in adults by Kikuchi et al [2] and Duarte et al [5]. Notably, Duarte et al [5] performed LV apical thrombectomy by using a 10-mm scope to access the LV in transverse aortotomy, which is a similar method to that used in the present case.…”

Section: Discussionmentioning

confidence: 85%

“…For its evacuation, an incision has to be made in the free wall of the left ventricle, and the surgeon must check the structure within the other ventricles before removal. However, this process may cause fatal cardiac dysfunction or arrhythmias [2]. Further, for patients with acute myocardial infarction, the incision and suture of the fragile myocardium may cause serious bleeding complications [2].…”

Section: Discussionmentioning

confidence: 99%

“…However, this process may cause fatal cardiac dysfunction or arrhythmias [2]. Further, for patients with acute myocardial infarction, the incision and suture of the fragile myocardium may cause serious bleeding complications [2]. If intra-ventricular visualization can be done effectively, the possibility of severe heart failure, arrhythmias, and bleeding complications, which may be caused by the incision and suture, may be reduced.…”

Section: Discussionmentioning

confidence: 99%

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A Treatment Case of Endoscopic Removal of Left Ventricular Thrombus, During Coronary Artery Bypass Graft

Park

Ryu

Cho

et al. 2014

Korean J Thorac Cardiovasc Surg

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Left ventricular thrombus is a common complication related to acute myocardial infarction. Removing this with an incision of the free wall of the left ventricle may cause fatal cardiac dysfunction or arrhythmias. Furthermore, performing incision and suture on the fragile myocardium of an acute myocardial infarction patient may cause serious bleeding complications. If there is a patient with left ventricular thrombus who needs thoracotomy for another reason, the case is attempted with the thought that if effective intraventricular visualization and manipulation can be done, fatalities caused by incision and suture may be reduced. For patients undergoing cardiopulmonary bypass, if intracardiac manipulation is required, an endoscope can be used, and given the potential complications after the incision and suturing of the infarcted tissue, the benefits are deemed sufficient.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Treatment Case of Endoscopic Removal of Left Ventricular Thrombus, During Coronary Artery Bypass Graft

Park

Ryu

Cho

et al. 2014

Korean J Thorac Cardiovasc Surg

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“…The most common type of endoscopic device used was rigid endoscope [1, 5, 8, 12–14, 19, 22, 23, 32, 33, 36, 37], reported in 13 studies. This was followed by semi-rigid endoscopes in four [7, 9, 21, 29], flexible endoscopes in three [2, 3, 30] and mixture of rigid and flexible endoscopes in one study [11].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of left ventricular cardio-endoscopic surgery

Soylu

Kidher

Ashrafian

et al. 2017

J Cardiothorac Surg

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Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique. There were no mortalities (0%; 0/47). In 12 studies, the follow-up period was longer than 30 days. There were no post-operative complications apart from one case of atrial fibrillation (2.2%; 1/46). Complete resection of left ventricular lesion was achieved in all cases (100%; 50/50). These successful results demonstrate that the cardio-endoscopic technique is a useful adjunct in resection of left ventricular tumours, thrombus and hypertrophic myocardium. This approach facilitates accurate resection of pathological tissue from left ventricle whilst avoiding exposure related valvular damage and adverse effects associated with ventriculotomy. Future research should focus on designing adequately powered comparative randomised trials focusing on major cardiac and cerebrovascular morbidity outcomes in both the short and long-term. In this way, we may have a more comprehensive picture of both the safety and efficacy of this technique and determine whether such devices could be safely adopted for routine use in minimal access or robotic intra-cardiac surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-017-0599-z) contains supplementary material, which is available to authorized users.

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Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report

Eranki

Villanueva

Collins

et al. 2021

J Cardiothorac Surg

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Introduction Left ventricular (LV) thrombus is a complication of acute myocardial infarction and is associated with systemic thromboembolism. We describe a trans-aortic endoscopic approach to the removal of an LV thrombus in a patient undergoing concurrent coronary artery bypass grafting and aortic valve replacement. Case presentation A 47 year old male presented following an embolic middle cerebral artery stroke and underwent transthoracic echocardiography demonstrating a mobile LV thrombus. Additional investigation revealed a moderately stenosed bicispid aortic valve, two vessel coronary artery disease and ischemic cardiomyopathy. The patient underwent early surgery to reduce the risk of further embolic episodes. A trans-aortic approach was utilized with videoscopy and single shafted instrumentation to aide in removal of the thrombus. The patient then underwent aortic valve replacement and coronary artery bypass grafting. Conclusion We report an alternative technique for the removal of a left ventricular thrombus in a patient undergoing concurrent coronary and aortic valve surgery. The transaortic video-assisted approach provided excellent visualisation of the apex and near complete removal of the thrombus without damaging the surrounding trabeculae. The main benefit of this technique is sparing of LV tissue, thereby preserving left ventricular function.

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Video-assisted transaortic left ventricular thrombectomy and coronary artery bypass grafting

Cited by 3 publications

References 7 publications

A Treatment Case of Endoscopic Removal of Left Ventricular Thrombus, During Coronary Artery Bypass Graft

A Treatment Case of Endoscopic Removal of Left Ventricular Thrombus, During Coronary Artery Bypass Graft

A systematic review of left ventricular cardio-endoscopic surgery

Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report

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