A Case of Thrombectomy for Loeffler’s Endocarditis

TL;DR

A 74-year-old man with Loeffler’s endocarditis underwent successful thrombectomy after anticoagulation failed, showing surgery can help prevent complications.

Contribution

This case report highlights the rare use of surgical thrombectomy as an effective treatment for Loeffler’s endocarditis.

Findings

Thrombectomy via a trans-left ventricular approach successfully removed a mobile thrombus in a patient with Loeffler’s endocarditis.

The patient recovered well with no recurrence of thrombus or cardiac deterioration after surgery and steroid therapy.

Abstract

Loeffler’s endocarditis, characterized by eosinophilic infiltration leading to thrombus formation and fibrosis in the ventricle, is associated with severe complications, such as embolism and heart failure. While anticoagulation and steroids are standard treatments, surgical thrombectomy is rarely reported. This is a case report of a 74-year-old man presented with an abnormal electrocardiogram. Echocardiography revealed a 38 × 29 mm mass in the left ventricular apex, and blood studies revealed hypereosinophilia, leading to a diagnosis of Loeffler’s endocarditis. Despite warfarin treatment, the thrombus persisted. The left ventricular intracardiac thrombus exhibited significant mobility, and we decided to perform a thrombectomy via a trans-left ventricular approach. After the surgery, steroid therapy was initiated. The patient recovered without recurrence of the thrombus or deterioration in cardiac function. Left ventricular thrombectomy for Loeffler’s endocarditis is considered a beneficial option to prevent thrombosis.

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