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Войти в исследования JTCVS structural and endovascular · 2025
Vacuum-assisted thrombectomy for intracardiac and intravascular thrombi: A single-center experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Carroll Adam M, Bakdash Kenaz, Ghincea Christian, Chanes Nicolas, Schramm Kristofer, Seres Tamas, Reece T Brett, Zipse Matthew, Reyes Robert, Casadaban Leigh, Rochon Paul J, Aftab Muhammad
Аннотация
OBJECTIVE: Percutaneous vacuum-assisted mechanical thrombectomy using venovenous bypass is a potential alternative to open surgery for the removal of intracardiac and intravascular/caval thrombi. We sought to evaluate the unique role and efficacy of this procedure in the treatment of high-risk patients deemed poor candidates for surgical thrombectomy.
METHODS: Between May 2015 and October 2023, 40 patients underwent vacuum-assisted thrombectomy for intracardiac or caval thrombi using venovenous bypass at our medical center. Patient and case characteristics, procedural details, and postprocedural outcomes were collected retrospectively. All procedures involved a multidisciplinary approach by cardiac surgeons, interventional radiologists, and cardiac anesthesiologists. Cardiac electrophysiologists also participated in the procedures when patients needed concomitant cardiovascular implantable electronic device system extractions.
RESULTS: Mean age of patients was 50 ± 16 years. Indications included indwelling catheter thrombus (n = 10; 25%), cardiovascular implantable electronic device infection (n = 12, 30%), tricuspid endocarditis (n = 8, 20%), and bland and tumor thrombus (n = 11, 28%, n = 7, 18%, respectively). Successful removal rate (>70% of thrombus removed) was 85% (n = 34). Interventional adjuncts included cardiovascular implantable electronic device lead extraction (n = 10, 25%) and snaring from contralateral access site (n = 7, 18%). In-hospital and 30-day mortality were 5% (n = 2) and 8% (n = 3), respectively. Complications included postoperative red blood cell transfusion (n = 5, 13%), pulmonary embolism (n = 2, 5%), and recurrent thrombosis (n = 2, 5%). Median total follow-up time was 16 ± 3 months, with either complete resolution or decreased burden of residual thrombus.
CONCLUSIONS: Vacuum-assisted thrombectomy is a rapid, effective, and safe technique when treating critically ill patients with acute intracardiac and caval thrombi and vegetation. It can be a highly valuable adjunct when treating poor candidates for open cardiovascular surgery.
METHODS: Between May 2015 and October 2023, 40 patients underwent vacuum-assisted thrombectomy for intracardiac or caval thrombi using venovenous bypass at our medical center. Patient and case characteristics, procedural details, and postprocedural outcomes were collected retrospectively. All procedures involved a multidisciplinary approach by cardiac surgeons, interventional radiologists, and cardiac anesthesiologists. Cardiac electrophysiologists also participated in the procedures when patients needed concomitant cardiovascular implantable electronic device system extractions.
RESULTS: Mean age of patients was 50 ± 16 years. Indications included indwelling catheter thrombus (n = 10; 25%), cardiovascular implantable electronic device infection (n = 12, 30%), tricuspid endocarditis (n = 8, 20%), and bland and tumor thrombus (n = 11, 28%, n = 7, 18%, respectively). Successful removal rate (>70% of thrombus removed) was 85% (n = 34). Interventional adjuncts included cardiovascular implantable electronic device lead extraction (n = 10, 25%) and snaring from contralateral access site (n = 7, 18%). In-hospital and 30-day mortality were 5% (n = 2) and 8% (n = 3), respectively. Complications included postoperative red blood cell transfusion (n = 5, 13%), pulmonary embolism (n = 2, 5%), and recurrent thrombosis (n = 2, 5%). Median total follow-up time was 16 ± 3 months, with either complete resolution or decreased burden of residual thrombus.
CONCLUSIONS: Vacuum-assisted thrombectomy is a rapid, effective, and safe technique when treating critically ill patients with acute intracardiac and caval thrombi and vegetation. It can be a highly valuable adjunct when treating poor candidates for open cardiovascular surgery.