DOI: 10.2459/01.jcm.0001096280.83699.1a ISSN: 1558-2027

A HUGE IMPELLA-RELATED AORTIC THROMBUS IN A D-LVAD PATIENT SUCCESSFULLY TREATED WITH THE INARI FLOWTRIEVER SYSTEM

A. Loforte, A. Spitaleri, G. Monteleone, P. Abbà, G. A. Galanti, V. Aloi, A. Sandoval, G. Gallone, A. Di Scalzi, A. C. Trompeo, M. Boffini, M. Rinaldi

Micro-axial flow pumps (mAFPs), eventually associated with ECLS, have emerged as a valid option to treat cardiogenic shock as a bridge to durable LVAD (d-LVAD) therapy.

We describe the case of a 55-year-old man with acute myocardial infarction-related cardiogenic shock (AMI-CS) who was bridged from ECMELLA to d-LVAD. He subsequently developed early right heart failure and required a temporary right ventricular assist device (t-RVAD). Four days later the RV function recovered, and TEE showed an incidental huge floating thrombus in the descending aorta. Despite anticoagulation, the thrombus remained stable. However, fibrinolysis wasn’t a suitable option due to high bleeding risk of pre-existing cerebral lesions thus, after a multidisciplinary team discussion (cardiac surgeons, anesthesiologists, interventional radiologists), we decided for mechanical thrombectomy using the FlowTriever System (Inari Medical, Irvine, CA).

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