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Eur J Cardiothorac Surg 2008;33:115. doi:10.1016/j.ejcts.2007.10.019
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Large thrombus on a cardiac defibrillator lead

Giuseppe Tavilla*

Department of Cardio-thoracic Surgery, Leiden University Medical Center, K6-S, PO Box 9600, 2300 RC Leiden, The Netherlands

Received 7 September 2007; received in revised form 12 October 2007; accepted 15 October 2007.

* Corresponding author. Tel.: +31 71 5262348; fax: +31 71 5248284. (Email: gtavilla{at}lumc.nl).

Key Words: Intracardiac thrombi • Cardiac defibrillator • Intracardiac leads

Several years after an anterior wall infarction, a 62-year-old man experienced a cardiac arrest with successful resuscitation. An internal cardiac defibrillator was implanted. Five years later, echocardiography showed a large thrombus attached to the right ventricle lead (Figs. 1 and 2 ). Thrombus removal, left ventricle remodeling, mitral and tricuspidal annuloplasty were successfully performed.


Figure 1
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  		Fig. 1. Echocardiography: apical cardiac four-chamber view with the large thrombus (arrows) on the cardiac defibrillator (Prizm VR1850, Guidant Inc.) lead across the tricuspid valve. RA: right atrium; RV: right ventricle: LA: left atrium; LV: left ventricle.

 

Figure 2
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  		Fig. 2. Intraoperative view of the thrombus across the tricuspid valve. Since insertion of the defibrillator, the patient was in sinus rhythm with anticoagulation therapy (fenprocoumon). SVC: superior vena cava; TV: tricuspid valve; L: lead of the cardiac defibrillator.

 





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Giuseppe Tavilla
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Right arrow Cardiac - other
Right arrow Electrophysiology - arrhythmias

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