The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


How should I treat a TAVI-eligible patient with a left ventricular thrombus and rapid clinical deterioration?

EuroIntervention 2017;12:2033-2036. DOI: 10.4244/EIJ-D-16-00338

1. 2nd Department of Cardiology, National and Kapodistrian University of Athens School of Medicine, Attikon University Hospital, Haidari, Greece; 2. Department of Cardiothoracic Surgery, National and Kapodistrian University o


BACKGROUND: An 89-year-old male with heart failure due to severe aortic stenosis and chronic renal failure was scheduled for transcatheter aortic valve implantation (TAVI).

INVESTIGATION: The day before the procedure the patient underwent an echocardiogram (as per in-house pre-procedural protocol). A large mobile thrombus was discovered at the left ventricular apex, and the TAVI procedure was cancelled.

DIAGNOSIS: Severe calcific aortic stenosis with a large mobile intracavitary thrombus.

MANAGEMENT: As the patient presented four weeks later with worsening symptoms of acute heart failure and could not be weaned from intravenous furosemide, the Heart ...

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