Aortic root thrombus complicated by left main coronary artery occlusion visualized by 3D echocardiography in a
Monique S Tanna1, Alex Reyentovich1, Leora B Balsam2
1Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Insights
A rare aortic root thrombus complication occurred in a patient with a continuous-flow left ventricular assist device (LVAD). Three-dimensional echocardiography was used to characterize this LVAD-associated thrombus, offering insights into its management.
Area of Science:
- Cardiovascular Medicine
- Medical Device Technology
- Echocardiography
Background:
- Aortic root thrombus is an infrequent complication in patients with continuous-flow left ventricular assist devices (LVADs).
- Ischemic cardiomyopathy necessitates advanced heart failure support, such as LVAD implantation.
- LVADs are crucial for improving survival and quality of life in advanced heart failure.
Abstract:
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients. To our knowledge, this is the first report of three-dimensional echocardiography used to characterize an LVAD-associated aortic root thrombus.
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