AngioJet rheolytic thrombectomy for thrombotic myocardial injury in a 15-year-old cystic fibrosis patient during lung transplantation

The Annals of Thoracic Surgery
Don HayesCharles W Hoopes

Abstract

We report on an acute myocardial injury caused by thrombotic emboli during off-pump bilateral sequential lung transplantation in a 15-year-old female patient with end-stage cystic fibrosis. A few minutes after reperfusion of the right (second sequential) allograft, the patient developed hemodynamic collapse, including hypotension, acute akinesis of the anterior and lateral myocardial walls, and severe mitral regurgitation. Thrombus was noted within the left atrium and ventricle on intraoperative transesophageal echocardiogram. After emergent cannulation for cardiopulmonary bypass, the patient underwent left cardiac catheterization with AngioJet rheolytic thrombectomy and removal of the clot from the distal left anterior descending coronary artery. Reperfusion was established without the need for stent placement or further intervention. The patient required short-term life support with venoarterial extracorporeal membrane oxygenation.

References

Jun 1, 1995·The Annals of Thoracic Surgery·D A WallerJ H Dark
Oct 8, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lorraine B WareMichael A Matthay
Nov 1, 2005·The Journal of Thoracic and Cardiovascular Surgery·Takahiro OtoGregory I Snell
May 3, 2006·Journal of Interventional Cardiology·Amgad N MakaryusRajiv Jauhar
Jul 24, 2007·The Annals of Thoracic Surgery·José PadillaFrancisco Vera-Sempere
Sep 22, 2009·Transplantation Proceedings·K NajafizadehH R K Vishteh
Nov 6, 2009·Clinical Transplantation·Marta López-SánchezFelipe Zurbano-Goñi

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