Right heart thrombi in transit represent deep venous thrombi that have mobilized and become lodged in the right heart en route to the pulmonary arteries, with the potential to migrate and lead to additional embolic complications. Due to their increased risk for mortality, right heart thrombi in transit represent a severe form of venous thromboembolism. In addition, in patients with patent foramen ovale (PFO) or atrial septal defect (ASD), right heart thrombi in transit can lead to systemic thromboembolism. Once diagnosed, right heart thrombi in transit require consideration of emergent treatment such as thrombolytics, surgical thromboembolectomy, or catheter-based intervention, due to the potential of the clot to fragment or migrate leading to further vascular obstruction and hemodynamic compromise.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Emergency Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Right heart thrombi in pulmonary embolism: results from the International Cooperative Embolism Registry.J Am Coll Cardiol. 2003; 41: 2245-2251
- Prevalence and prognostic significance of right-sided cardiac mobile thrombi in acute massive pulmonary embolism.Am J Cardiol. 1997; 79: 1433-1435
- Review of echocardiographically diagnosed right heart entrapment of pulmonary emboli-in-transit with emphasis on management.Am Heart J. 1987; 113: 171-178
- Treatment of right heart thromboemoli.Chest. 2002; 121: 806-814
- Floating right heart thrombi and pulmonary embolism: diagnosis, outcome, and therapeutic management.Cardiology. 1996; 87: 169-174
- Successful treatment of right heart thromboemboli with IV recombinant tissue-type plasminogen activator during continuous echocardiographic monitoring: a case series report.Chest. 1999; 116: 78-82
- Mobile thrombi of the right heart in pulmonary embolism: delayed disappearance after thrombolytic treatment.Chest. 2005; 127: 1051-1053
- Non-surgical extraction of right cardiac “thrombus in transit.”.Catheter Cardiovas Interv. 2000; 51: 316-319
- Percutaneous removal of a large mobile right atrial thrombus using a basket retrieval device.Catheter Cardiovasc Interv. 2000; 51: 479-482
- Free- floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients.Circulation. 1999; 99: 2779-2783
Published online: January 17, 2015
Accepted: November 16, 2014
Received in revised form: October 10, 2014
Received: July 16, 2014
Streaming video: One brief real-time video clip that accompanies this article is available in streaming video at www.journals.elsevierhealth.com/periodicals/jem. Click on Video Clip 1.
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.