We report a case of left main coronary artery thrombosis 7 days after aortic valve replacement for native aortic valve regurgitation. The patient had undergone apicoaortic conduit implantation 3 years earlier. The thrombosis resulted from deviation of the cardiac output through the apicoaortic conduit and consequent turbulence of flow in the ascending aorta. Despite thrombus aspiration from the left main coronary artery, the patient never recovered and died 2 days later from multiple organ failure.
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