Non-ST elevation myocardial infarction from aortic root thrombus after LVAD placement.

Area of Science:

• Cardiology
• Cardiovascular Surgery

Background:

• Aortic root thrombosis (ART) is a rare but serious complication after continuous-flow left ventricular assist device (CF-LVAD) implantation.
• Idiopathic non-ischaemic cardiomyopathy is a condition affecting heart muscle function.

Purpose of the Study:

• To report a case of non-ST elevation myocardial infarction (NSTEMI) secondary to ART in a CF-LVAD patient.
• To discuss the potential under-recognition and management of ART in this patient population.

Main Methods:

• Case presentation of a patient with idiopathic non-ischaemic cardiomyopathy and CF-LVAD.
• Conservative management including antiplatelet therapy and an increased international normalized ratio (INR) goal.
• Follow-up imaging to assess thrombus resolution.

Main Results:

• The patient developed NSTEMI due to ART post-CF-LVAD placement.
• Conservative treatment led to the resolution of aortic root thrombus.
• ART may be an under-recognized complication associated with CF-LVAD.

Conclusions:

• Conservative management with antiplatelet therapy and an increased INR goal is a viable approach for NSTEMI secondary to ART in CF-LVAD patients.
• Individualized, multidisciplinary management is crucial for these complex cases.
• Blood stasis at the aortic root may contribute to ART development in CF-LVAD patients.