CONCLUSIONS Coronary occlusion as a result of aortic thrombosis is a rare but catastrophic complication of venoarterial ECMO as a bridge to delayed surgery for post-MI VSR. During this highly thrombogenic period, LV pulsatility and aortic valve opening must be strictly preserved and heparin therapy closely monitored. A heart transplant should be considered in the most severe cases when the risk of surgical repair is considered too high.
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