Surgical treatment of a left ventricular apical thrombus via robotic surgery

Bolcal, Cengiz; Kadan, Murat; Kubat, Emre; Erol, Gökhan; Doğancı, Suat

doi:10.1111/jocs.14000

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…There is a few data of NOAC use in TTS patients (Mano et al, 2016;Bolcal et al, 2019;Ohashi et al, 2015). Although many patients have complete resolution with anticoagulant therapy, recurrent embolic phenomena are a common complication, as seen in our patient.…”

Section: Management Of the Left Ventricular Thrombosissupporting

confidence: 48%

Thromboembolic complications in Takotsubo Syndrome during Covid-19 outbreak. A review with case report

Kolbakir¹,

Yücel²,

Deşer³

et al. 2021

JECM

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New coronavirus (COVID-19) outbreak, which started in Wuhan, China and spread rapidly all over the world, has become the most important cause of the emotional distress for susceptible people. Because the people also remained in fear and anxiety during the period when the elderly population in the whole country was desperate due to the COVID-19 outbreak and was asked to stay at home in fear of death. In addition, the fact that the patients were hospitalized together with COVID-19 patients caused his psychological distress to be experienced even more. Takotsubo Syndrome (TTS) is known as a distress-induced transient left ventricular dysfunction. In our patient with TTS, it was found that a new apical thrombus, which was not seen in the left ventricle, was seen in previous echo and computerized tomographic investigation, and that it was a source of thromboemboli, by stress triggering neurocardiac reactions. While under the medical treatment of viral pneumonia, under the Coronavirus transmission measures, thrombus in the LV was removed by being taken to the emergency open heart surgery. Our case is the first patient in the literature where a new thrombus developed in the LV and splenic infarction in TTS triggered by the pandemic. In this article; We have presented the experience of TTS triggered by pandemic, etiopathogenesis of left ventricular thrombus, open heart surgery indications when COVID-19 is suspected, coronavirus transmission measures in the surgical approach, the postoperative treatment and literature is reviewed.

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Section: Management Of the Left Ventricular Thrombosissupporting

confidence: 48%

Thromboembolic complications in Takotsubo Syndrome during Covid-19 outbreak. A review with case report

Kolbakir¹,

Yücel²,

Deşer³

et al. 2021

JECM

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“…The daVinci ® SI model (Intuitive Surgical Inc.,) was used. We described our standard robotic set‐up and surgical technique in our previous papers 3–5 . Briefly, common femoral vein was used for inferior caval decompression and right jugular vein was used for superior caval decompression.…”

Section: Methodsmentioning

confidence: 99%

“…We described our standard robotic set-up and surgical technique in our previous papers. [3][4][5] Briefly, common femoral vein was used for inferior caval decompression and right jugular vein was used for superior caval decompression. In these cases, superior caval cannula was placed more superior than other robotic procedures to allow superior caval clamping (detailed below).…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic repair of atrial septal defect with partial pulmonary venous return anomaly: Our 5 year experience

Kadan

Erol

Kubat

et al. 2022

Robotics Computer Surgery

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Introduction: Partial pulmonary venous return anomalies (PPVRA) were not considered as a good candidate for robotic surgery in early time of robotic cardiac surgery. In this study, we present our experience in patients undergoing robotic atrial septal defect (ASD) and PPVRA surgery.Methods: Between November 2014 and January 2020, data of 21 patients underwent robotic ASD with PPVRA was collected. Inclusion criterion was presence of right-sided PPVRA with ASD. All operations were performed robotically. Results:The mean age of patients was 26.7 � 10.3 years. Seventeen patients (81%) had superior-caval ASD with supracardiac PPVRA and double-patch technique was used. Four patients had inferior-caval ASD with intracardiac PPVRA and singlepatch technique was preferred. Cross-clamp time and cardiopulmonary bypass time were 92.8 � 29.6 and 127.8 � 38.1, respectively. There was no mortality. One patient had atrioventricular-block and required pacemaker. Conclusion:Robotic repair of ASD with PPVRA is feasible and effective method as an alternative to conventional surgery.

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“…Surgical removal of the LVT is an option for patients with high embolic risk undergoing other open-heart surgery or at the time of transition from peripheral to central VA-ECMO configuration (106). The high morbidity and mortality of this approach outweigh the benefits of performing surgery solely for the indication of LVT (51).…”

Section: Surgical Thrombectomymentioning

confidence: 99%

Management of left ventricular thrombus: a narrative review

2021

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Left ventricular thrombus (LVT) is a serious complication of acute myocardial infarction (MI) and also non-ischemic cardiomyopathies. We performed a narrative literature review, manual-search of reference lists of included articles and relevant reviews. Our literature review indicates that the incidence of LVT following acute MI has decreased, probably due to improvement in patient care as a result of better and earlier reperfusion techniques. Predictors of LVT include anterior MI, involvement of left ventricular (LV) apex (regardless of the coronary territory affected), LV akinesis or dyskinesis, reduced LV ejection fraction (LVEF), severe diastolic dysfunction and large infarct size. LVT is associated with increased risk of systemic embolism, stroke, cardiovascular events and death, and there is evidence that anticoagulant therapy for at least 3 months can reduce the risk of these events. Cardiac magnetic resonance (CMR) has the highest diagnostic accuracy for LVT, followed by echocardiography with the use of echocardiographic contrast agents (ECAs). Although current guidelines suggest use of vitamin K antagonist (VKA) for a minimum of 3 to 6 months, there is growing evidence of the benefits of direct acting oral anticoagulants in treatment of LVT. Embolic events appear to occur even after resolution of LVT suggesting that anticoagulant therapy needs to be considered for a longer period in some cases. Recommendations for the use of triple therapy in the presence of the LVT are mostly based on extrapolation from outcome data in patients with atrial fibrillation (AF) and MI. We conclude that the presence of LVT is more likely in patients with anterior STsegment elevation MI (STEMI) (involving the apex) and reduced ejection fraction (EF). LVT should be considered a marker of increased long-term thrombotic risk that may persist even after thrombus resolution.Ongoing clinical trials are expected to elucidate the best management strategies for patients with LVT.

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Surgical treatment of a left ventricular apical thrombus via robotic surgery

Cited by 9 publications

References 9 publications

Thromboembolic complications in Takotsubo Syndrome during Covid-19 outbreak. A review with case report

Thromboembolic complications in Takotsubo Syndrome during Covid-19 outbreak. A review with case report

Robotic repair of atrial septal defect with partial pulmonary venous return anomaly: Our 5 year experience

Management of left ventricular thrombus: a narrative review

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