Patient characteristics that increase the risk of continuous-flow left ventricular assist device thrombosis have not been well established. We report a case of HeartWare thrombosis in a patient with aspirin hyporesponsiveness, and discuss the role of platelet function testing in preventing this severe complication. There is a need for clinical trials determining optimal antiplatelet therapy in patients supported with left ventricular assist devices, and consensus regarding modification of antiplatelet therapy after device thrombosis.
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