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

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).