# Multiple Left Ventricular Ball Thrombi in a Patient With Nonischemic Cardiomyopathy Bridged to Heart-Lung Transplantation

## TL;DR

A patient with severe heart failure and a large heart clot was successfully treated with a heart-lung transplant.

## Contribution

This case highlights successful management of complex heart failure and thrombus via heart-lung transplantation.

## Key findings

- A patient with nonischemic cardiomyopathy and a large left ventricular thrombus was treated with heart-lung transplant.
- Combined heart-lung transplantation successfully managed cardiogenic shock and severe pulmonary hypertension.
- The patient had an uneventful recovery after the transplant.

## Abstract

We present a case of a young patient with a history of recurrent venous thromboembolism, stroke status post fibrinolysis, and titin-related dilated cardiomyopathy who developed cardiogenic shock in the setting of decompensated heart failure and concomitant large left ventricular thrombus comprising ∼75% of the cavity. Her shock was managed medically as she was evaluated for surgical heart failure therapies. The patient underwent a combined heart-lung transplant and was discharged after an uneventful postoperative course.

This case demonstrates that concomitant end-stage heart failure, large intracardiac thrombus, and severe pulmonary hypertension can be managed successfully with combined heart-lung transplantation.