Novel Approach Using Aspiration Thrombectomy for Aortic Root Thrombus After LVAD Implantation.

BACKGROUND

Left ventricular assist devices (LVADs) have become a cornerstone in the management of advanced heart failure. However, they are also associated with a range of complications, among which the development of an aortic root thrombus is particularly serious.

CASE SUMMARY: A 72-year-old man developed refractory ventricular arrhythmias shortly after implantation of a HeartMate 3 LVAD, and he was found to have an aortic root thrombus extending into the left main artery. Given his high surgical risk, we performed to our knowledge the first documented percutaneous aspiration thrombectomy of the aortic root thrombus, leading to resolution and clinical recovery.

DISCUSSION: This case underscores the importance of early recognition and highlights a novel approach to managing aortic root thrombi in LVAD patients.

TAKE-HOME MESSAGES: Early recognition of aortic root thrombi is critical. Percutaneous aspiration thrombectomy is a viable, innovative option for select LVAD patients at high surgical risk.