ST-Segment Elevation Myocardial Infarction Secondary to Aortic Root Thrombosis in a Patient With a Left Ventricular Assist Device

Abstract

Aortic root thrombosis (ART) is a rare but serious complication of continuous-flow left ventricular assist device (LVAD) support that can result in coronary artery occlusion. We present a 66-year-old man with a HeartMate 3 LVAD who presented with ST-segment elevation myocardial infarction (STEMI). Urgent coronary angiography revealed an aortic root thrombus with complete ostial right coronary artery (RCA) occlusion. He underwent successful percutaneous coronary intervention with drug-eluting stent placement. His course was complicated by ventricular fibrillation and right ventricular shock, followed by clinical recovery. This case highlights ART as an uncommon cause of acute myocardial infarction in LVAD-supported patients and emphasizes the importance of prompt recognition and management of ischemic complications in this population.