Key result
Intensified antithrombotic therapy resolves aortic root thrombus without requiring surgical intervention.
Why the study?
Aortic root thrombosis is a rare but serious and potentially under-recognised complication following continuous-flow LVAD placement that can cause NSTEMI.
Does conservative management with antiplatelets and higher INR goals safely resolve aortic root thrombosis in CF-LVAD patients presenting with NSTEMI?
Case Report (n=1)
Does conservative management with antiplatelets and higher INR goals safely resolve aortic root thrombosis in CF-LVAD patients presenting with NSTEMI?
Highlights that conservative medical management using dual antiplatelet therapy and increased INR goals is a feasible, non-invasive alternative for treating ART-induced NSTEMI in CF-LVAD patients who are at prohibitive surgical risk.
Aortic root thrombosis (ART) is a rare but serious complication following the placement of continuous-flow left ventricular assist devices (CF-LVAD). We present the case of a patient with idiopathic non-ischaemic cardiomyopathy who developed a non-ST elevation myocardial infarction (NSTEMI) secondary to ART after CF-LVAD placement. The patient was treated conservatively with antiplatelet therapy and increased international normalized ratio (INR) goal with resolution of thrombus on repeat imaging. ART may be an under-recognised complication in patients with CF-LVAD. Stasis of blood at the aortic root in patients with CF-LVAD may contribute to the development of ART. Management of these patients presenting with myocardial infarction should be individualised by using a multidisciplinary team approach. Our case report suggests conservative management of NSTEMI secondary to ART in patients with CF-LVAD with antiplatelet therapy and an increased INR goal as a reasonable treatment approach.
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Holtz et al. (2025) conducted a case report in Aortic root thrombosis with NSTEMI post CF-LVAD placement (n=1). Conservative management (antiplatelet therapy and increased INR goal) was evaluated on Resolution of aortic root thrombus. Conservative management with antiplatelet therapy and an increased INR goal successfully resulted in the resolution of the aortic root thrombus without surgical intervention.
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