scholarly journals Acute pulmonary embolus with visible right heart thrombus in transit

2011 ◽  
Vol 29 (1) ◽  
pp. 72-73
Author(s):  
Michael Thomas Debney
Keyword(s):  
Pulmonary Embolus ◽  
Right Heart ◽  
Acute Pulmonary Embolus ◽  
In Transit

scholarly journals Acute pulmonary embolus with visible right heart thrombus in transit

2011 ◽  
Vol 2011 (sep13 1) ◽  
pp. bcr0720114553-bcr0720114553 ◽  
Author(s):  
M. T. Debney
Keyword(s):  
Pulmonary Embolus ◽  
Right Heart ◽  
Acute Pulmonary Embolus ◽  
In Transit

scholarly journals Right Heart Thrombus and Pulmonary Embolism in Patients with Life-Threatening Bleeding: Management of a Complex Condition

2021 ◽  
Author(s):  
Enrico Bentivegna ◽  
Michelangelo Luciani ◽  
Valerio Spuntarelli ◽  
Giorgio Sesti ◽  
Flavia Del Porto ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
Bleeding Risk ◽  
Right Heart ◽  
Bleeding Management ◽  
Critical Situation ◽  
Haemodynamic Parameters ◽  
Complex Patients ◽  
Life Threatening ◽  
Uncommon Condition ◽  
In Transit

AbstractRight heart thrombus (RHT) in transit is an uncommon condition associated with high mortality. Increased use of echocardiography has allowed an easier detection of RHT; however, there is no consensus about the most appropriate management of this critical situation. Therapeutic strategy should be decided according to patient’s haemodynamic parameters, clinical data, and bleeding risk. This paper, referring to the most current evidences, underlines the difficulty to establish the best therapeutic strategies in RHT among complex patients as there are no relevant guidelines. In some conditions, multidisciplinary management is the best way to find the most correct therapy despite the bad prognosis.

scholarly journals A Giant Right Heart Thrombus-in-Transit: The Challenge of Anticoagulation in Factor V Leiden Thrombophilia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Andrew Chu ◽  
Thu Thu Aung ◽  
Minni Shreya Arumugam ◽  
Mauricio Danckers ◽  
Mohi Mitiek ◽  
...  
Keyword(s):  
Oral Anticoagulants ◽  
Single Point ◽  
Factor V Leiden ◽  
Single Point Mutation ◽  
Homozygous Mutation ◽  
Factor V ◽  
Right Heart ◽  
Blood Clots ◽  
History Of ◽  
In Transit

Factor V Leiden (FVL) is an autosomal dominant condition resulting in thrombophilia. Factor V normally acts as a cofactor for prothrombinase, helping cleave prothrombin to thrombin. A single point mutation in it disrupts factor V, making it unreceptive to protein C and increasing the risk of thrombosis. FVL mutation associated with right heart thrombus is a rare entity. Right heart thrombus or right heart thrombus-in-transit is associated with high mortality. We present a 51-year-old male with a past medical history of FVL homozygous mutation and recurrent blood clots, who has failed multiple different oral anticoagulants. He presented to the hospital with symptoms of shortness of breath and subsequently found to have a giant right heart thrombus. He was treated with surgical embolectomy. This case underscores the challenges faced by patients with FVL and recurrent blood clots.

A Doppler Echocardiographic Pulmonary Flow Marker of Massive or Submassive Acute Pulmonary Embolus

2019 ◽  
Vol 32 (7) ◽  
pp. 799-806 ◽  
Author(s):  
Luis Afonso ◽  
Aditya Sood ◽  
Emmanuel Akintoye ◽  
John Gorcsan ◽  
Mobeen Ur Rehman ◽  
...  
Keyword(s):  
Pulmonary Embolus ◽  
Acute Pulmonary Embolus ◽  
Pulmonary Flow

scholarly journals P689 Surgical treatment of a right heart thrombus-in-transit with massive bilateral pulmonary embolism

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C M Angelescu ◽  
I Hantulie ◽  
Z Galajda ◽  
I Mocanu ◽  
A T Paduraru ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Atrium ◽  
Intracardiac Thrombus ◽  
Severe Pulmonary Hypertension ◽  
Right Heart ◽  
Right Pulmonary Artery ◽  
The Right ◽  
In Transit ◽  
Right Heart Dysfunction

Abstract Introduction Right heart thrombi are rare, found in up to 20% of pulmonary emboli (PE), and associated with significantly increased mortality(1). A thrombus entrapped in a PFO is a rare form of right heart thromboembolism. Clinical Case A 73-year-old male patient who had dyspnea for 10 days, was transferred to our hospital for the surgical treatment of a cardiac tumor. We performed TTE which revealed a free floating, huge mass( measuring more than 8 cm long) in the right atrium, that protruded in the right ventricle, with high risk of embolization. Another smaller mass, attached to the interatrial septum. Severe right ventricular dysfunction and severe pulmonary hypertension were present. Contrast-enhanced computer tomography was performed, which revealed severe bilateral pulmonary artery emboli with complete occlusion of right pulmonary artery branch. Clinical and paraclinical data strongly suggested that the huge cardiac mass was a thrombus that originated from the lower extremity veins. TEE showed that the thrombus was entrapped through the PFO, with a smaller part in the left atrium and the biggest portion in the right atrium. The patient underwent an emergent on-pump surgical cardiac and right pulmonary artery embolectomy. The right atrium was opened and a huge intracardiac thrombus with a lengh of 14 cm extending from the coronary sinus, to PFO in the left atrium and also in the right ventricle was removed. The right branch of the pulmonary artery was opened and a large volume of clot- 9 cm long- was removed. The patient was removed from cardio-pulmonary by-pass (CPB) on high doses of norepinephrine and dobutamine and necessitated initiation of venous-arterial ECMO to support the severe right heart dysfunction. He was extubated after 10 days, with little improvement in the clinical status. Transthoracic echocardiography showed smaller right heart cavities), normal left ventricular function, but persistent severe RV dysfunction and severe pulmonary hypertension. In the thirteenth postoperative day, he installed cardio-respiratory arrest and he died. Discussion In this report we describe a case of a patient with a huge intracardiac thrombus, entrapped through a PFO, associated with massive pulmonary embolism, with late presentation in our hospital and severe refractory right heart dysfunction. He underwent successful embolectomy, which is a unique procedure in the treatment of an acute pulmonary embolism and entrapped thrombus in a PFO. Conclusion The treatment of choice for emboli-in-transit is controversial. In a recent review, surgical thromboembolectomy showed a trend toward improved survival and significantly reduced systemic emboli compared to anticoagulation. Thrombolysis in these patients may cause fragmentation of thrombus and systemic embolization, resulting in increased mortality. Management decisions should be made with multidisciplinary coordination and consideration of complicating factors such as PFO. Abstract P689 Figure. Extensive biatrial thrombus

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