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Mobile left ventricular thrombus in left ventricular dysfunction: case report and review of literature.
MedLine Citation:
PMID:  23584757     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Left ventricular (LV) thrombi carry a high risk of embolization. Therapeutic recommendations like treatment with low molecular heparin and intravenous unfractionated heparin (UFH), thrombolysis or surgical thrombectomy have failed to reach a consensus. CASE DESCRIPTION: A 56-year-old female patient presented in cardiogenic shock to the emergency department. Echocardiography demonstrated a dilated LV with a severely depressed global systolic function and a large LV apical thrombus. Treatment with UFH was initiated as well as a treatment with catecholamines for stabilizing the patient's hemodynamic situation. On the follow-up echocardiographic examination, extensive free-floating parts of the thrombus could be documented. Given the high risk of embolization in a now hemodynamically stable situation, emergency surgical embolectomy was performed. DISCUSSION: A conservative procedure might be useful for bridging till surgical treatment is available and/or the risk due to surgery is acceptable. CONCLUSION: In absence of evidence-based guidelines for the treatment of LV thrombi, individualized management options concerning surgical, embolization and bleeding risk must be taken into account.
Authors:
Jürgen Leick; Sebastian Szardien; Christoph Liebetrau; Matthias Willmer; Ulrich Fischer-Rasokat; Jörg Kempfert; Holger Nef; Andreas Rolf; Thomas Walther; Christian Hamm; Helge Möllmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-14
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  -     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestr. 2-8, 61231, Bad Nauheim, Germany.
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