CTICasesLVAD-Induced Aortic Valve Stagnancy with Sinus of Valsalva Thrombus
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Imaging findings
CT of the abdomen/chest shows a left ventricular assist device (LVAD) in place. Contrast-enhanced CT reveals a hyperdense filling defect (thrombus) in the non-coronary sinus of Valsalva. Follow-up imaging after a period of anticoagulation shows complete resolution of the filling defect.
Key takeaways
In patients with an LVAD, the high continuous output of the pump can significantly decrease the transvalvular gradient across the native aortic valve, keeping it closed and causing blood flow in the aortic root and sinuses of Valsalva to become stagnant. This stasis is a well-known risk factor for thrombus formation at the sinus of Valsalva, which can resolve with systemic anticoagulation.
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