Huge thrombus formation in the left ventricle during bilateral CentriMag ventricular assist device with successful bridging to heart transplantation: a case report and review of the literature.

Owing to shortage of donor hearts, the ventricular assist device is used as a bridging therapy to heart transplantation. However, thrombus formation is a critical complication during ventricular assist device circulatory support that might result in ischemic infarction of end organs. Here, we report a patient diagnosed with decompensated dilated cardiomyopathy and cardiogenic shock who underwent emergent extracorporeal life support, and subsequent temporary bilateral ventricular assistance with the CentriMag device (Levitronix LLC, Waltham, MA). Daily transthoracic echocardiography did not detect any thrombus formation, and no stroke event occurred during biventricular support. During eventual orthotopic heart transplantation, transesophageal echocardiography detected a huge thrombus in the left ventricle. We removed the biventricular assist device, excised the recipient heart, cleaned up the thrombus, and then implanted the donor heart successfully. No stroke or transient neurological deficit was noted during or after the transplantation. The patient was discharged 14 days after transplantation. No major adverse cardiovascular event was noted during 2 years of outpatient follow-up.