Aortic Root Thrombus in a Left Ventricular Assist Device Patient as a Cause for Intractable Ventricular Tachycardia

TL;DR

A rare case shows that a blood clot near the aortic root in a heart device patient can cause severe heart rhythm issues and may require early surgery.

Contribution

This case demonstrates the feasibility of early surgical management for aortic root thrombosis causing intractable ventricular tachycardia.

Findings

Aortic root thrombus extending into the left main coronary artery caused intractable ventricular tachycardia in a left ventricular assist device patient.

Early surgical management was successfully used for aortic root thrombosis, unlike typical conservative approaches.

Anticoagulation and aortic valve opening limitations are important factors in managing this condition.

Abstract

Aortic root thrombosis (ART) is an uncommon complication after left ventricular assist device implantation. We describe a unique postoperative presentation of intractable ventricular tachycardia as a result of an aortic root thrombus extending into the left main coronary artery. This case highlights the importance of a high degree of suspicion and anticoagulation for ART in the setting of intractable postoperative ventricular tachycardia and limited opening of the aortic valve. Second, whereas most reported cases of ART have been managed conservatively by optimizing left ventricular assist device speed and anticoagulation, we demonstrate the feasibility of early surgical management.

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