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.