Left ventricular (LV) thrombus after acute myocardial infarction (AMI) is a frequent complication that is associated with a risk of systemic embolism. Essential thrombocythemia (ET) has opposing tendencies towards hemorrhage and thrombogenesis and it can cause AMI via thrombogenesis. Ball-like LV thrombus is associated with a high risk of systemic embolism. We describe surgical resection of LV ball-like thrombus from a patient with ET. A 60-year-old woman presented at our hospital with transient ischemic attack accompanied by transient hemiplegia. Ultrasonic cardiography revealed a mobile ball-like thrombus in the LV after transmural AMI of the anterior wall. We performed emergency LV thrombectomy because of the mobile LV thrombus with embolism. Platelet aberrations and pathological bone marrow findings were consistent with a diagnosis of ET. We administered the patient with anti-coagulation drugs and the DNA replication inhibitor hydroxycarbamide to decrease the platelet count. She continues to survive and is doing well without major postoperative complications. <Learning objective: Essential thrombocythemia (ET) can cause acute myocardial infarction with left ventricular (LV) thrombus via thrombogenesis. After we describe surgical resection of LV ball-like thrombus from a patient with ET, the patient was administered with anti-coagulation drugs and the DNA replication inhibitor hydroxycarbamide to decrease the platelet count. The patient continues to survive and is doing well without major postoperative complications.>.
Keywords: Acute myocardial infarction; Ball-like thrombus; Myeloproliferative diseases; Surgical resection.