{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T10:20:57Z","timestamp":1756635657535,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Large right atrial thrombi represent medical emergencies due to their potential for fatal embolization. Treatment options vary based on thrombus etiology and morphology, and include: (i) anticoagulation alone, (ii) a combination of anticoagulation and thrombolysis, (iii) transcatheter thrombectomy, and (iv) surgical thrombectomy. Here, we report the youngest and smallest patient to date to successfully undergo right atrial thrombectomy using the novel \u014cN\u014c transcatheter retrieval system (\u014cN\u014cCOR LLC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 8-year-old male with Hodgkin's lymphoma was diagnosed with a new large, mobile thrombus associated with a port-a-cath in the right atrium on routine pre-chemotherapy echocardiogram. He was otherwise asymptomatic with a structurally normal heart. Thrombolysis with alteplase was initially attempted but was unsuccessful due to anaphylaxis. The patient subsequently underwent a partial thrombectomy of the mobile portion of the thrombus using the \u014cN\u014c retrieval device, successfully reducing the risk of catastrophic embolization. Follow-up echocardiography at twelve weeks and seven months confirmed further reduction in thrombus size and calcification of the remnant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This patient presented a unique therapeutic dilemma due to several factors, including hypermobile thrombus of substantial size, recent oncologic diagnosis, and anaphylaxis to alteplase. The novel \u014cN\u014c was effective in encapsulating the entire thrombus, securing fragments, and thereby reducing risk of embolization during retrieval. This approach also minimized blood loss and avoided the complications associated with invasive cardiothoracic surgery in a patient with underlying malignancy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf314","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T08:17:50Z","timestamp":1752740270000},"source":"Crossref","is-referenced-by-count":1,"title":["Effective removal of a large, mobile right atrial thrombus with the \u014cN\u014c retrieval device: a novel case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7320-554X","authenticated-orcid":false,"given":"Victoria Y","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Paediatric Cardiology, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]},{"name":"Division of Paediatric Critical Care, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9173-4960","authenticated-orcid":false,"given":"W Wyatt","family":"Lindsey","sequence":"additional","affiliation":[{"name":"Division of Paediatric Cardiology, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]},{"name":"Alabama College of Osteopathic Medicine , Division of Clinical Sciences, 445 Health Sciences Blvd, Dothan, AL ,","place":["36303, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7264-2721","authenticated-orcid":false,"given":"Swati","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Paediatric Critical Care, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinjal","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Paediatric Cardiology, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6527-0496","authenticated-orcid":false,"given":"Catherine E","family":"Tomasulo","sequence":"additional","affiliation":[{"name":"Division of Paediatric Cardiology, Inova L.J. Murphy Children\u2019s Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"2025072508011720500_ytaf314-B1","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1182\/bloodadvances.2018024786","article-title":"American society of hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism","volume":"2","author":"Monagle","year":"2018","journal-title":"Blood Adv"},{"key":"2025072508011720500_ytaf314-B2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/1358863X15569009","article-title":"Comparative efficacy of different modalities for treatment of right heart thrombi in transit: a pooled analysis","volume":"20","author":"Athappan","year":"2015","journal-title":"Vasc Med"},{"key":"2025072508011720500_ytaf314-B3","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1378\/chest.121.3.806","article-title":"Treatment of right heart thromboemboli","volume":"121","author":"Rose","year":"2002","journal-title":"Chest"},{"key":"2025072508011720500_ytaf314-B4","first-page":"283","article-title":"Cardiac surgery in patients with a history of malignancy: increased complication rate but similar mortality","volume":"21","author":"Chan","year":"2012","journal-title":"Heart Lung Circ"},{"key":"2025072508011720500_ytaf314-B5","first-page":"893","article-title":"Right atrial thrombus removal with use of the \u014cN\u014c retrieval device","volume":"102","author":"Herron","year":"2023","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025072508011720500_ytaf314-B6","first-page":"1","article-title":"First-in-paediatric uses of a mechanical aspiration system for percutaneous removal of right atrial masses","volume":"20","author":"Daniels","year":"2023","journal-title":"Cardiol Young"},{"key":"2025072508011720500_ytaf314-B7","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac244","article-title":"2022 ESC guidelines on cardio-oncology developed in collaboration with the European hematology association (EHA), the European society for therapeutic radiology and oncology (ESTRO) and the international cardio-oncology society (IC-OS)","volume":"43","author":"Lyon","year":"2022","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf314\/63783437\/ytaf314.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf314\/63783437\/ytaf314.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf314\/63783437\/ytaf314.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T12:01:31Z","timestamp":1753444891000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf314\/8204451"}},"subtitle":[],"editor":[{"given":"Flemming Javier","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Vasilios","family":"Giampatzis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Milenko Zoran","family":"Cankovic","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Spinthakis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":7,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf314","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,7,1]]},"article-number":"ytaf314"}}