Percutaneous Mechanical Aspiration of an Aortic Root Thrombus Causing a Myocardial Infarction.

BACKGROUND

Left ventricular assist devices (LVADs) are critical for patients with end-stage cardiomyopathy but complications, such as aortic root thrombus (ART), are present in up to 10% of cases. ART management is challenging, with limited therapeutic options.

CASE SUMMARY: A 54-year-old female with an LVAD presented with acute chest pain and a thrombus in the left coronary cusp. She was treated with successful percutaneous mechanical aspiration (PMA) of the aortic root and coronary arteries. Her international normalized ratio target was increased, and she has not had a recurrence of her ART.

DISCUSSION: ART in LVAD patients often arises from impaired aortic valve opening, promoting thrombus formation. This case demonstrates the utility of PMA as a safe and effective alternative to surgical removal.

TAKE-HOME MESSAGES: ART is a critical complication of LVADs, requiring prompt diagnosis and treatment. PMA can offer a definitive and safe treatment option for ART in select patients.