biostudies-literatureUnknown30(22)Eyekpegha J<h4>Background</h4>Left ventricular thrombi may complicate acute myocardial infarction, and anticoagulation is the mainstay of management. Surgical thrombectomy may be considered in some patients with a perceived high risk for thromboembolism if there is another indication for urgent cardiac surgery.<h4>Case summary</h4>A 43-year-old diabetic man presented with a non-ST-segment elevation myocardial infarction and an acute left ventricular thrombus. He had a transaortic thrombectomy and coronary artery bypass graft.<h4>Discussion</h4>The usual approach for surgical thrombectomy is left ventriculotomy. This however may cause deterioration of left ventricular function. A left atrial approach has also been described but access may be challenging. A video-assisted transaortic left ventriculoscopy combines excellent visualization provided by the endoscope and avoidance of a left ventriculotomy.<h4>Take-home messages</h4>Surgical thrombectomy may be beneficial in a select group of patients with acute left ventricular thrombus. A video-assisted transaortic approach provides excellent access and visualization in these patients.JACC. Case reports104567https://www.ebi.ac.uk/biostudies/studies/S-EPMC12426540biostudies-literatureTransaortic Extraction of Left Ventricular Thrombus.PMC12426540Ruiz Segria COwens WAWilliams PDEyekpegha JKrishnan SVfalseTransaortic Extraction of Left Ventricular Thrombus.<h4>Background</h4>Left ventricular thrombi may complicate acute myocardial infarction, and anticoagulation is the mainstay of management. Surgical thrombectomy may be considered in some patients with a perceived high risk for thromboembolism if there is another indication for urgent cardiac surgery.<h4>Case summary</h4>A 43-year-old diabetic man presented with a non-ST-segment elevation myocardial infarction and an acute left ventricular thrombus. He had a transaortic thrombectomy and coronary artery bypass graft.<h4>Discussion</h4>The usual approach for surgical thrombectomy is left ventriculotomy. This however may cause deterioration of left ventricular function. A left atrial approach has also been described but access may be challenging. A video-assisted transaortic left ventriculoscopy combines excellent visualization provided by the endoscope and avoidance of a left ventriculotomy.<h4>Take-home messages</h4>Surgical thrombectomy may be beneficial in a select group of patients with acute left ventricular thrombus. A video-assisted transaortic approach provides excellent access and visualization in these patients.2025-01-01T00:00:00Z2025 Aug2026-04-08T19:54:33.357Z2026-04-08T14:36:16.076ZS-EPMC124265404078079410.1016/j.jaccas.2025.104567