Characteristics of left ventricular thrombus resulting in perioperative embolism. A complication of coronary artery bypass grafting.

A review of perioperative complications of cardiac procedures at Tampa General Hospital revealed a distinct preoperative finding in several patients having embolism after coronary artery bypass grafting (CABG). From a total of over 10,000 cardiac catheterization procedures, four patients had ventricular wall motion abnormalities with discrete, mobile, pedunculated filling defects noted during ventriculography. Three of these patients eventually underwent CABG, and each had a postoperative embolic episode. A similar catheterization finding was noted in a fourth patient, who later had an embolic event. Thus, even in the absence of a discrete aneurysm, this observation suggests the need for an aggressive surgical approach to CABG patients with these ventricular filling defects.