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

EuroIntervention Journal

Consult your peers’ treatment and different viewpoints of the case «a TAVI-eligible patient with a left ventricular thrombus and rapid clinical deterioration», published in the EuroIntervention Journal by S. Deftereos, et al.

First, I would have checked for another reason for this worsening situation. Serial troponin measures and a coronary angiogram would have allowed the ruling out of silent acute coronary syndrome and potentially changed the antithrombotic regimen.

If there was no concomitant coronary artery disease, I would bridge VKA to parenteral heparin and perform TAVI immediately, given the rapid dissolution of the apical thrombus. This thrombus appears organised, flat and at low risk of embolisation.

Consult the EIJ article

Authors

Deftereos S, Giannopoulos G, Raisakis K, Vrettou AR, Kolokathis F, Zacharoulis A, Angouras D, Alexopoulos D, Lekakis J, Eggebrecht H, Lämmer J, Papadopoulos N, Collet JP

Disclaimer

This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.