The Intracardiac Masses That Wouldn't Melt: Wrong Diagnosis or Wrong Treatment - A Case Report.

A 64-year-old woman with biventricular cardiomyopathy and a cardiac resynchronization device developed recurrent spontaneous sub-segmental pulmonary emboli. Large mobile intracardiac masses adherent to all three leads were detected and failed to regress with sequential trials of antithrombotic therapy. Surgical intervention was deemed high-risk. The masses were successfully aspirated percutaneously using the AlphaVac F1885 percutaneous mechanical aspiration system (AngioDynamics, Inc) under trans-esophageal and fluoroscopic guidance, which is the first reported use of this recently CE-marked device for extracting large right atrial masses in Europe. There was no evidence of recurrent masses at thirty-day follow-up. Histopathological analysis confirmed organized thrombi.