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Aortic root thrombus causing non-ST elevation myocardial infarction after left ventricular assist device.

MedStar author(s):

Citation: Perfusion. :2676591221096228, 2022 Apr 20PMID: 35442104Institution: MedStar Washington Hospital CenterDepartment: Internal Medicine Residency | Internal Medicine Residency | Medicine/Pulmonary-Critical Care | Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022 ISSN:

0267-6591

Name of journal: PerfusionAbstract: A 61-year-old male presented with a history of ischemic cardiomyopathy requiring left ventricular assist device (LVAD) implantation 9 months prior to presentation. The patient was on aspirin and warfarin as part of his LVAD management. The patient had chest pain and was found to have non-ST elevation myocardial infarction. Despite being on warfarin, a subtherapeutic international normalized ratio of 1.6 was measured on admission. Lactate dehydrogenase was 694 U/L (12-146) and high-sensitivity troponin peaked at 47,093 ng/L. Left heart catheterization revealed an extensive aortic root thrombus (AT). AT is an uncommon cause of thromboembolic events in long-term LVAD patients. Thrombotic events in LVAD patients are pump thrombosis, cerebrovascular accidents, heparin-induced thrombocytopenia, and rarely, AT. There is no well-described management of such a rare complication. In our report, we suggest a multidisciplinary approach and consideration of conservative treatment of these patients.All authors: Bien-Aime F, Jawaid Y, Kallur AS, Sallam T, Zaaqoq AMFiscal year: FY2022 Digital Object Identifier:

https://dx.doi.org/10.1177/02676591221096228

ORCID:

https://orcid.org/0000-0003-3164-344X https://orcid.org/0000-0003-3147-5044 https://orcid.org/0000-0003-3164-344X https://orcid.org/0000-0003-3147-5044
https://orcid.org/0000-0003-3164-344X https://orcid.org/0000-0003-3147-5044 https://orcid.org/0000-0003-3164-344X https://orcid.org/0000-0003-3147-5044

Date added to catalog: 2022-05-11

Holdings ( 1 )
Title notes ( 2 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	35442104	Available		35442104

A 61-year-old male presented with a history of ischemic cardiomyopathy requiring left ventricular assist device (LVAD) implantation 9 months prior to presentation. The patient was on aspirin and warfarin as part of his LVAD management. The patient had chest pain and was found to have non-ST elevation myocardial infarction. Despite being on warfarin, a subtherapeutic international normalized ratio of 1.6 was measured on admission. Lactate dehydrogenase was 694 U/L (12-146) and high-sensitivity troponin peaked at 47,093 ng/L. Left heart catheterization revealed an extensive aortic root thrombus (AT). AT is an uncommon cause of thromboembolic events in long-term LVAD patients. Thrombotic events in LVAD patients are pump thrombosis, cerebrovascular accidents, heparin-induced thrombocytopenia, and rarely, AT. There is no well-described management of such a rare complication. In our report, we suggest a multidisciplinary approach and consideration of conservative treatment of these patients.

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