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

Krish C. Dewan MD , Alejandro A. Lobo MD , Zachary W. Fitch MD , Alejandro Murillo MD , Angela Pollak MD, FASE , Alina Nicoara MD, FASE , Violet G. Johnston BS , Carmelo A. Milano MD
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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.
左心室辅助装置患者主动脉根部血栓是难治性室性心动过速的原因
主动脉根部血栓形成(ART)是左心室辅助装置植入后的罕见并发症。我们描述了一个独特的术后表现难治性室性心动过速的结果主动脉根部血栓延伸到左主干冠状动脉。本病例强调了在术后难治性室性心动过速和主动脉瓣开放受限的情况下,高度怀疑和抗凝治疗ART的重要性。其次,尽管大多数报道的ART病例都是通过优化左室辅助装置速度和抗凝来保守管理的,但我们证明了早期手术管理的可行性。
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