{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:56:25Z","timestamp":1792457785913,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The presence of right heart thrombi in transit (RHTiT) in the setting of acute pulmonary embolism (PE) is associated with high mortality. The optimal management in such cases is inconclusive. We present the results of surgical treatment of 20 consecutive patients diagnosed with high- or intermediate-high-risk PE with coexisting RHTiT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A retrospective analysis was performed of all consecutive patients undergoing surgical treatment in the Medicover Hospital between 2013 and 2021 for acute PE with coexisting thrombi in-transit in right heart cavities. The diagnosis was based on echocardiography, computed tomography pulmonary angiography and laboratory tests. Eligibility criteria for surgical treatment were acute PE with RHTiT, right ventricular overload on imaging studies and significantly elevated levels of cardiac troponin and NTproBNP. All patients were operated on with extracorporeal circulation using deep hypothermia and total circulatory arrest. The primary end point was hospital all-cause mortality; secondary end points were perioperative complications and long-term mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The analysis included 20 patients. There was no in-hospital death. Nearly one-third of patients required temporal hemofiltration for postoperative renal failure, but this did not involve the need for dialysis at discharge. No neurological complications occurred in any patient. The mean follow-up was 46\u2009months (range 13\u201398). There was 1 death in the long-term follow-up, not related to PE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgical treatment of patients with acute PE and coexisting RHTiT can provide favourable results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad022","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T13:01:11Z","timestamp":1674219671000},"source":"Crossref","is-referenced-by-count":11,"title":["Acute pulmonary embolism with coexisting right heart thrombi in transit\u2014surgical treatment of 20 consecutive patients"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0988-9913","authenticated-orcid":false,"given":"Dariusz","family":"Zieli\u0144ski","sequence":"first","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"},{"name":"Faculty of Medicine, Lazarski University , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Zygier","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"},{"name":"Faculty of Medicine, Lazarski University , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Dyk","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"},{"name":"Faculty of Medicine, Lazarski University , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryszard","family":"Wojdyga","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"},{"name":"Faculty of Medicine, Lazarski University , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"},{"name":"Faculty of Medicine, Lazarski University , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewelina","family":"Pirsztuk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medicover Hospital , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Szostakiewicz","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medicover Hospital , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Szatkowski","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medicover Hospital , Warsaw, Poland"},{"name":"Department of Anaesthesiology, National Institute of Cardiology , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8298-9243","authenticated-orcid":false,"given":"Szymon","family":"Darocha","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre , Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-469X","authenticated-orcid":false,"given":"Marcin","family":"Kurzyna","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre , Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8393-5415","authenticated-orcid":false,"given":"Micha\u0142","family":"Ciurzy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Medical University of Warsaw , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6833-1066","authenticated-orcid":false,"given":"Micha\u0142","family":"Machowski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Medical University of Warsaw , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-0000","authenticated-orcid":false,"given":"Piotr","family":"Pruszczyk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Medical University of Warsaw , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-8832","authenticated-orcid":false,"given":"Adam","family":"Torbicki","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre , Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Biederman","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Medicover Hospital , Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"2023042703320449900_ezad022-B1","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1161\/CIRCRESAHA.115.306841","article-title":"Global burden of thrombosis: epidemiologic aspects","volume":"118","author":"Wendelboe","year":"2016","journal-title":"Circ Res"},{"key":"2023042703320449900_ezad022-B2","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1183\/13993003.01044-2016","article-title":"Right heart thrombi in pulmonary embolism","volume":"48","author":"Barrios","year":"2016","journal-title":"Eur Respir J"},{"key":"2023042703320449900_ezad022-B3","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1016\/S0735-1097(03)00479-0","article-title":"Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry","volume":"41","author":"Torbicki","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"2023042703320449900_ezad022-B4","first-page":"528","article-title":"Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience","volume":"13","author":"Ak\u0131ll\u0131","year":"2013","journal-title":"Anadolu Kardiyol Derg"},{"key":"2023042703320449900_ezad022-B5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.thromres.2020.01.006","article-title":"Pulmonary embolism with clot in transit: an analysis of risk factors and outcomes","volume":"187","author":"Garvey","year":"2020","journal-title":"Thromb Res"},{"key":"2023042703320449900_ezad022-B6","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"key":"2023042703320449900_ezad022-B7","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.33963\/KP.a2021.0130","article-title":"Pulmonary embolism response team: A multidisciplinary approach to pulmonary embolism treatment. Polish PERT Initiative Report","volume":"79","author":"Araszkiewicz","year":"2021","journal-title":"Kardiol Pol"},{"key":"2023042703320449900_ezad022-B8","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/oxfordjournals.eurheartj.a059427","article-title":"The European working group on echocardiography. The European cooperative study on the clinical significance of right heart thrombi","volume":"10","year":"1989","journal-title":"Eur Heart J"},{"key":"2023042703320449900_ezad022-B9","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1183\/13993003.00819-2015","article-title":"Outcome of patients with right heart thrombi\u2014Right Heart Thrombi European Registry","volume":"47","author":"Ko\u0107","year":"2016","journal-title":"Eur Respir J"},{"key":"2023042703320449900_ezad022-B10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.chest.2016.09.038","article-title":"Prognostic significance of right heart thrombi in patients with acute symptomatic pulmonary embolism: systematic review and meta-analysis","volume":"151","author":"Barrios","year":"2017","journal-title":"Chest"},{"key":"2023042703320449900_ezad022-B11","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1378\/chest.121.3.806","article-title":"Treatment of right heart thromboemboli","volume":"121","author":"Rose","year":"2002","journal-title":"Chest"},{"key":"2023042703320449900_ezad022-B12","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":"2023042703320449900_ezad022-B13","doi-asserted-by":"crossref","first-page":"2338","DOI":"10.21037\/jtd.2018.04.41","article-title":"Early surgical treatment in patients with pulmonary embolism and thrombus-in-transit","volume":"10","author":"Galeano-Valle","year":"2018","journal-title":"J Thorac Dis"},{"key":"2023042703320449900_ezad022-B14","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1378\/chest.127.3.1051","article-title":"Mobile thrombi of the right heart in pulmonary embolism","volume":"127","author":"Ferrari","year":"2005","journal-title":"Chest"},{"key":"2023042703320449900_ezad022-B15","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/0002-8703(89)90274-3","article-title":"Efficacy of treatment of patients with echocardiographically detected right-sided heart thrombi: a meta-analysis","volume":"118","author":"Kinney","year":"1989","journal-title":"Am Heart J"},{"key":"2023042703320449900_ezad022-B16","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.amjmed.2016.11.027","article-title":"Treatment of right heart thrombi associated with acute pulmonary embolism","volume":"130","author":"Barrios","year":"2017","journal-title":"Am J Med"},{"key":"2023042703320449900_ezad022-B17","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.ajem.2017.10.045","article-title":"Floating right heart thrombi: a pooled analysis of cases reported over the past 10 years","volume":"36","author":"Burgos","year":"2018","journal-title":"Am J Emerg Med"},{"key":"2023042703320449900_ezad022-B18","doi-asserted-by":"crossref","first-page":"e623","DOI":"10.4244\/EIJ-D-22-00246","article-title":"Percutaneous treatment options for acute pulmonary embolism: a clinical consensus statement by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function and the European Association of Percutaneous Cardiovascular Interventions","volume":"18","author":"Pruszczyk","year":"2022","journal-title":"EuroIntervention"},{"key":"2023042703320449900_ezad022-B19","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1177\/1358863X211073974","article-title":"Procedural outcomes associated with use of the AngioVac system for right heart thrombi: a safety report from RAPID registry data","volume":"27","author":"Moriarty","year":"2022","journal-title":"Vasc Med"},{"key":"2023042703320449900_ezad022-B20","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jvir.2020.09.012","article-title":"Endovascular removal of thrombus and right heart masses using the AngioVac system: results of 234 patients from the prospective, multicenter Registry of AngioVac Procedures in Detail (RAPID)","volume":"32","author":"Moriarty","year":"2021","journal-title":"J Vasc Interv Radiol"},{"key":"2023042703320449900_ezad022-B21","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.carrev.2019.12.020","article-title":"Percutaneous vacuum-assisted thrombectomy using AngioVac aspiration system","volume":"21","author":"Rajput","year":"2020","journal-title":"Cardiovasc Revasc Med"},{"key":"2023042703320449900_ezad022-B22","first-page":"181","article-title":"Transesophageal echocardiography diagnosis of tricuspid valve injury during AngioVac percutaneous pulmonary embolectomy","volume":"2","author":"Boisen","year":"2018","journal-title":"CASE (Phila)"},{"key":"2023042703320449900_ezad022-B23","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jvir.2016.01.012","article-title":"Early experience with AngioVac aspiration in the pulmonary arteries","volume":"27","author":"Al-Hakim","year":"2016","journal-title":"J Vasc Interv Radiol"},{"key":"2023042703320449900_ezad022-B24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.amsu.2018.11.010","article-title":"Case report: re-emerging significance of surgical embolectomy in pulmonary embolism","volume":"39","author":"Kay","year":"2018","journal-title":"Ann Med Surg (Lond)"},{"key":"2023042703320449900_ezad022-B25","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1002\/ccd.29391","article-title":"Catheter directed embolectomy of right atrial clot in transit\u2014a case series","volume":"97","author":"Verma","year":"2021","journal-title":"Catheter Cardiovasc Interv"},{"key":"2023042703320449900_ezad022-B26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ejvssr.2019.10.001","article-title":"Right atrial and massive pulmonary artery mechanical thrombectomy under echocardiography guidance using the FlowTriever system","volume":"45","author":"Nezami","year":"2019","journal-title":"EJVES Short Rep"},{"key":"2023042703320449900_ezad022-B27","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1161\/01.CIR.97.19.1946","article-title":"Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism","volume":"97","author":"Konstantinides","year":"1998","journal-title":"Circulation"},{"key":"2023042703320449900_ezad022-B28","doi-asserted-by":"crossref","first-page":"776","DOI":"10.4070\/kcj.2016.0295","article-title":"Systematic review of treatment for trapped thrombus in patent foramen ovale","volume":"47","author":"Seo","year":"2017","journal-title":"Korean Circ J"},{"key":"2023042703320449900_ezad022-B29","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1159\/000177081","article-title":"Floating right heart thrombi and pulmonary embolism: diagnosis, outcome and therapeutic management","volume":"87","author":"Chapoutot","year":"1996","journal-title":"Cardiology"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad022\/48800255\/ezad022.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/4\/ezad022\/50105197\/ezad022.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/4\/ezad022\/50105197\/ezad022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T03:32:49Z","timestamp":1682566369000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad022\/6994185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,20]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad022","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,1]]},"published":{"date-parts":[[2023,1,20]]},"article-number":"ezad022"}}