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J Thorac Cardiovasc Surg 2003;125:204-205
© 2003 The American Association for Thoracic Surgery

Brief Communications

Left ventricular thrombectomy in a cocaine user with normal coronary arteries

S. Fortier, MDa, R. G. Demaria, MD, PhDa,c, G. B. Pelletier, MDb, M. Carrier, MDa, L. P. Perrault, MD, PhDa Montreal, Quebec, Canada, and Montpellier, France

From the Departments of Surgerya and Cardiology,b Montreal Heart Institute, Montreal, Quebec, Canada, and the Cardiovascular Surgery Unit,c Arnaud de Villeneuve Teaching Hospital, Montpellier, France.

Received for publication April 18, 2002. Accepted for publication May 1, 2002. Address for reprints: L. P. Perrault, MD, PhD, Research Center, Montreal Heart Institute, 5000 Belanger St E, Montreal, Quebec, Canada H1T 1C8 (E-mail: lpperrau@icm.umontreal.ca).

The first 20% of the full text of this article appears below.

Formation of a left ventricular (LV) thrombus may follow an anterior acute myocardial infarction (AMI) and is associated with a significant risk of systemic embolization.Go 1 A 37-year-old man was seen at a referring hospital with acute ischemia of the right lower limb with pain, paresthesia, and paresis. There was a history of cocaine use by inhalation, with description of anginal pain during bouts of drug use and a more sustained episode of thoracic pain about 4 months before admission. There were no signs or symptoms of congestive heart failure. A successful right femoral thrombectomy was performed with general anesthesia, and intravenous heparin therapy was instituted. The electrocardiogram on admission revealed an anteroseptal myocardial infarction of undetermined date. A transthoracic echocardiogram was performed to identify the source of embolism and revealed a severe LV dysfunction with an ejection fraction of 30%. The transesophageal echocardiogram showed an apical mural thrombus with a . . . [Full Text of this Article]




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