Management of extensive intracardiac thombosis in a patient with polycythemia vera undergoing coronary artery bypass grafting.

ABSTRACT

Polycythemia vera (PV) is a chronic myeloproliferative disorder with a predilection for thrombotic complications in affected patients. Intracardiac thrombosis is a rare manifestation of this disease, as documented in only a few published cases. In this report, we describe a PV patient who suddenly developed extensive thrombosis within all four cardiac chambers and severe ventricular dysfunction during a coronary artery bypass procedure. We also detail the intraoperative salvage maneuvers implemented in this case, which included deep hypothermic circulatory arrest with retrocerebral perfusion and four chamber thrombectomy.