Successful treatment of ventricular assist device associated ventricular thrombus with systemic tenecteplase

The Jarvik 2000 Flowmaker® is an implantable left-ventricular assist device (LVAD) that produces axial-flow by means of a single, rotating, vaned impeller which eliminates the need for valves, an internal compliance chamber, or an externalised vent.1 A known complication of continuous, axial-flow LVADs is thrombosis within the left ventricle, adjacent to the device\u27s inflow conduit with subsequent inflow obstruction manifesting as recurrent heart failure. Delgado et al. reported two cases in which a catheter was used to continuously infuse recombinant tissue plasminogen activator (tPA) into the left ventricle until signs of successful thrombolysis was achieved.2 We report a case of intracardiac thrombus successfully treated with a single dose of peripherally administered thrombolytic