Discontinuation of aspirin before non-cardiac surgery causing ventricular mural thrombus for a patient with left ventricular aneurysm: a case report

Abstract

Background Left ventricular mural thrombus (LVMT) is a life-threatening complication in patients with left ventricular dysfunction. Case presentation A 67-year-old man had a history of penetrating myocardial infarction and left ventricular aneurysm (LVA). The patient was scheduled for a non-cardiac surgery and stopped aspirin for 10 days to reduce the risk of bleeding. Fresh LVMT was revealed via the transesophageal echocardiography (TEE) after the preoperative discontinuation of aspirin. Conclusions Perioperative repeated evaluation for the thrombosis by echocardiography is essential in cases of patients with cardiovascular disease undergoing non-cardiac surgery. In high risk patient, during temporary interruption of antiplatelets, bridging with perioperative low-molecular-weight heparin is advisable.