Surgical Treatment of Free-floating Thrombi in the Right Side of the Heart in Patients with Pulmonary Thromboembolism

Floating right heart thrombi (FRHTs are rare in patients with acute pulmonary thromboembolism (PTE. FRHTs are an extreme therapeutic emergency and any delay in treatment could be lethal. Heparin thrombolysis and catheter therapy are used most frequently to treat acute PTE. Here we present three cases involving operative treatment of FRHTs associated with PTE. Diagnose were made with echocardiography before proceeding to emergency surgery. Thromboembolectomy was performed on cardiopulmonary bypass. One patient became brain dead 10 days postoperatively owing to cardiopulmonary arrest before surgery. The two survivors were subsequently discharged home after uneventful recoveries. (J Nippon Med Sch 2006; 73: 33―37