-Report on Experiments and Clinical Cases-

Surgical Treatment of Free-floating Thrombi in the Right Side of the Heart in Patients with Pulmonary Thromboembolism

Shigeo Yamauchi¹, Yuji Maruyama², Shun-ichiro Sakamoto², Hajime Imura², Hidetsugu Ogasawara², Ken-ichi Yamada¹, Hideyuki Iwaki¹, Hiromasa Yamashita¹ and Kazuo Shimizu²

¹Department of Thoracic and Cardiovascular Surgery, Chiba-Hokusoh Hospital, Nippon Medical School
²Department of Surgery II, Nippon Medical School

Floating right heart thrombi (FRHTs) are rare in patients with acute pulmonary thromboembolism (PTE). FRHTs are an extreme therapeutic emergency, and any delay in treatment could be lethal. Heparin, thrombolysis, and catheter therapy are used most frequently to treat acute PTE. Here we present three cases involving operative treatment of FRHTs associated with PTE. Diagnose were made with echocardiography before proceeding to emergency surgery. Thromboembolectomy was performed on cardiopulmonary bypass. One patient became brain dead 10 days postoperatively owing to cardiopulmonary arrest before surgery. The two survivors were subsequently discharged home after uneventful recoveries.

J Nippon Med Sch 2006; 73: 33-37

Keywords
pulmonary thromboembolism, floating right heart thrombi

Correspondence to
Shigeo Yamauchi, MD, Department of Thoracic and Cardiovascular Surgery, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba-gun, Inba-mura, Chiba 270-1694, Japan
shigeo@nms.ac.jp

Received, October 4, 2005
Accepted, November 17, 2005