Case Report: HIT-related valve thrombosis in an LVAD patient

This report presents a case of a patient with a history of mechanical aortic valve replacement due to aortic valve disease, who underwent left ventricular assist device (LVAD) implantation combined with concomitant redo aortic valve replacement (using a bovine pericardial bioprosthesis). Postoperatively, the patient developed unstable LVAD parameters. Subsequent imaging revealed thrombus formation on the bioprosthetic aortic valve and within the perivalvular space. The patient subsequently underwent emergency aortic valve thrombectomy, during which a white thrombus was observed. Laboratory tests confirmed the diagnosis of heparin-induced thrombocytopenia (HIT). The anticoagulation regimen was promptly switched to the direct thrombin inhibitor argatroban, after which the patient's condition stabilized. This case highlights the diagnostic and therapeutic challenges of managing HIT-related thrombosis in the setting of continuous-flow LVAD support and aims to review the underlying pathophysiology and optimal anticoagulation strategy.