Cerebral embolism associated with left ventricular assist device support and successful therapy with intraarterial urokinase

A patient with a bioprosthetic aortic valve sustained a cerebral embolism during support with an implantable left ventricular assist device. This was lysed with intra-arterial urokinase with complete resolution of the neurological deficit. Subsequently the patient underwent heart transplantation and remains neurologically intact. This case report is the first successful use of thrombolysis for cerebral embolism associated with a mechanical assist device.