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Multiple left ventricular thrombus following coronary artery bypass graft: An uncommonly documented case report

Heart Science Journal · Vol. 7 No. 3 (2026) · hlm. 109–112

DOI
10.21776/ub.hsj.2026.007.03.19
ISSN
2721-9984, 2721-9976
Terbit
2026-07-14
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Left Ventricular Thrombus (LVT) formation after Coronary Artery Bypass Grafting (CABG) is infrequent but may result in life-threatening embolic events. The occurrence of LVT following CABG is linked to impaired left ventricular function, regional wall motion abnormalities (RWMAs), hypercoagulability, and an increased inflammatory response subsequent to heart surgery. The interplay of these factors predisposes patients to thrombus development, particularly in those with a history of myocardial infarction, reduced left ventricle ejection fraction (LVEF), pre-existing endothelial injury, or hypercoagulable conditions. Case Presentations: A 65-year-old female with reduced LVEF, 36% by biplane, and RWMAs developed multiple LVT following CABG, as revealed by serial transthoracic echocardiography on postoperative day 6. There was no intracardiac thrombus confirmed preoperatively by transthoracic echocardiography and intraoperatively by transesophageal echocardiography. On follow-up, hypercoagulable risk factors was observed, and adenocarcinoma was diagnosed by bone survey and ultrasound-guided biopsy, suggestive of a metastatic process. A complete resolution of multiple LVTs was achieved after three months of administration of warfarin 2mg daily. Conclusions: This case underscores the importance of echocardiography surveillance among high-risk populations postoperatively. Prompt identification and early initiation of anticoagulants showed to be beneficial in hypercoagulable conditions in carcinoma patient as reported in this case.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Mohammad Saifur RohmanUniversity of Brawijaya22
Cholid Tri TjahjonoUniversity of Brawijaya21
Ardian RizalUniversity of Brawijaya18
Djanggan SargowoUniversity of Brawijaya14
Budi SatrijoUniversity of Brawijaya13
Anna Fuji RahimahUniversity of Brawijaya11
Indra PrasetyaUniversity of Brawijaya9
Heny MartiniUniversity of Brawijaya8
Setyasih AnjarwaniUniversity of Brawijaya8
Seprian WidasmaraUniversity of Brawijaya4
Adhika Prastya WikanandaUniversity of Brawijaya4
Putri Annisa KamilaUniversity of Brawijaya4
Sawitri SatwikajatiUniversity of Brawijaya3
Dyah Ayu IkeningrumRSUD Prof. Dr. Saiful Anwar Malang3
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya3
Evit RuspionoAfiliasi tidak diketahui3
Nikhen NoverikeUniversity of Brawijaya3
Titin Andri WihastutiUniversity of Brawijaya3
Imam Mi'raj SuprayogaUniversity of Brawijaya3
Dea Arie KurniawanUniversity of Brawijaya3
Yoga WaranugrahaUniversity of Brawijaya2
Tonny AdriyantoUniversity of Brawijaya2
Irma KameliaUniversity of Brawijaya2
Oktafin Srywati PamunaUniversity of Brawijaya2
Zainal FathurohimUniversity of Brawijaya2
Ira Vori NugrohoUniversity of Brawijaya2
Zaki SaidiUniversity of Brawijaya2
Anna Fuji RahimahAfiliasi tidak diketahui2
Dedy IrawanUniversity of Brawijaya2
Muhammad Rizki FadlanUniversity of Brawijaya2
Imelda KrisnasariUniversity of Brawijaya2
Aloysius Yuwono SupraptaUniversity of Brawijaya2
Wella KarolinaUniversity of Brawijaya2
Yoseph Budi UtomoUniversity of Brawijaya1
Ryan RamadhanUniversity of Brawijaya1
Veny KurniawatiUniversity of Brawijaya1

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Multiple left ventricular thrombus following coronary artery bypass graft: An uncommonly documented case report</dc:title>
	<dc:creator xml:lang="en">Hutomo, Malombassi Dharmawan Hadiwidjojo</dc:creator>
	<dc:creator xml:lang="en">Kurnianingsih, Novi </dc:creator>
	<dc:creator xml:lang="en">Muttaqin, Chaidar </dc:creator>
	<dc:creator xml:lang="en">Widito, Sasmojo </dc:creator>
	<dc:subject xml:lang="en">Coronary Artery Bypass Graft (CABG)</dc:subject>
	<dc:subject xml:lang="en">Intracardiac Left Ventricular Thrombus</dc:subject>
	<dc:subject xml:lang="en">Hypercoagulable state</dc:subject>
	<dc:subject xml:lang="en">Carcinoma</dc:subject>
	<dc:subject xml:lang="en">Anticoagulants</dc:subject>
	<dc:description xml:lang="en">Background: Left Ventricular Thrombus (LVT) formation after Coronary Artery Bypass Grafting (CABG) is infrequent but may result in life-threatening embolic events. The occurrence of LVT following CABG is linked to impaired left ventricular function, regional wall motion abnormalities (RWMAs), hypercoagulability, and an increased inflammatory response subsequent to heart surgery. The interplay of these factors predisposes patients to thrombus development, particularly in those with a history of myocardial infarction, reduced left ventricle ejection fraction (LVEF), pre-existing endothelial injury, or hypercoagulable conditions.
Case Presentations: A 65-year-old female with reduced LVEF, 36% by biplane, and RWMAs developed multiple LVT following CABG, as revealed by serial transthoracic echocardiography on postoperative day 6. There was no intracardiac thrombus confirmed preoperatively by transthoracic echocardiography and intraoperatively by transesophageal echocardiography. On follow-up, hypercoagulable risk factors was observed, and adenocarcinoma was diagnosed by bone survey and ultrasound-guided biopsy, suggestive of a metastatic process. A complete resolution of multiple LVTs was achieved after three months of administration of warfarin 2mg daily.
Conclusions: This case underscores the importance of echocardiography surveillance among high-risk populations postoperatively. Prompt identification and early initiation of anticoagulants showed to be beneficial in hypercoagulable conditions in carcinoma patient as reported in this case.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2026-07-14</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20719</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2026.007.03.19</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease; 109-112</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2026.007.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20719/611</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2026 Malombassi Dharmawan Hadiwidjojo Hutomo, Novi  Kurnianingsih, Chaidar  Muttaqin, Sasmojo  Widito</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>