Stent Barrier Technique for Aortic Root Thrombus

Aortic root thrombus is a rare cause of acute coronary syndrome, often linked to hypercoagulability or structural anomalies. A 58-year-old male presented with chest pain, hypotension, and Killip Class 3 findings. Electrocardiography suggested left main coronary artery (LMCA) occlusion, and coronary angiography revealed a large thrombus extending from the LMCA into the left anterior descending artery (LAD). Computed tomography identified an organized thrombus in the noncoronary sinus of Valsalva. A drug-eluting stent protruding 8 mm into the aorta was implanted from the LMCA to the LAD as a bridge to surgery. Surgical thrombectomy and coronary artery bypass grafting were performed, and pathology confirmed an organized thrombus. The stent barrier technique stabilizes aortic root thrombi and prevents recurrent embolization in repeated embolic events. It may serve as a bridging strategy in centers with limited surgical facilities.