Abrupt formation and spontaneous resolution of a mobile right atrial thrombus following intraoperative cardiopulmonary resuscitation during da Vinci robotic-assisted surgery: a case report

Abstract

Right atrial thrombus is rare yet potentially life-threatening, carrying a substantial risk of pulmonary embolism and death. Management generally includes anticoagulation, thrombolysis, surgical thrombectomy, or catheter-based removal, whereas prognosis is poor when the thrombus remains untreated. We describe the intraoperative formation and spontaneous dissolution of a large, mobile right atrial thrombus that ultimately led to a favorable clinical outcome. During da Vinci robotic-assisted surgery, the patient experienced sudden cardiac arrest and was resuscitated with intraoperative cardiopulmonary resuscitation. Trans-esophageal echocardiography revealed a massive, free-floating thrombus in the right atrium, which subsequently resolved without the need for pharmacological or mechanical intervention.