ArticleCureus2025
Postoperative Left Anterior Descending Artery Compression and Left Ventricular Thrombus Following the Repair of a Penetrating Right Ventricular Injury in an Adolescent: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Intravascular ultrasound-guided percutaneous treatment of late-presenting left anterior descending artery compression after penetrating cardiac trauma in a young adult: a case report.European heart journal. Case reports · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Penetrating cardiac trauma in adolescents is rare. Perioperative myocardial infarction secondary to surgical repair with subsequent left ventricular (LV) thrombus is even more so. A 16-year-old male sustained a stab wound to the left anterior chest. He collapsed and was brought to the emergency department by the family in a peri-arrest state. Emergency sternotomy revealed a right ventricular (RV) free wall laceration adjacent to the left anterior descending artery (LAD), repaired with pledgeted sutures. The LAD appeared patent intraoperatively. Postoperatively, ECG demonstrated new ST elevation, and transoesophageal echocardiography demonstrated new regional wall motion abnormalities. Coronary angiography showed mid-LAD occlusion, considered secondary to extraluminal compression from local postoperative tissue swelling and/or pledget tension. Stenting was not pursued, as extrinsic compression is unlikely to be relieved by percutaneous coronary intervention, and reoperation was considered high risk immediately post-sternotomy. Transthoracic echocardiography later revealed severe LV systolic dysfunction (ejection fraction of 29%) and a 1.5 × 1.0 cm apical thrombus. Anticoagulation with enoxaparin was initiated and transitioned to warfarin, together with guideline-directed heart failure therapy. The patient recovered and was discharged on day 18 after admission. Follow-up echocardiography was planned at three months to reassess function and thrombus resolution. This case illustrates survival following penetrating RV injury complicated by perioperative LAD occlusion and subsequent ischemic LV dysfunction with thrombus, highlighting anticoagulation and heart failure management challenges in an adolescent.
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