Thromboses in the native aorta in patients with hypoplastic left heart syndrome.

We present four children with hypoplastic left heart syndrome (HLHS) and development of thrombus in the native aortic root. There are only two previously reported cases in the literature. In all four of our patients, thrombus was noted on transthoracic echocardiography. In one patient, surgical thrombectomy was performed, with subsequent deterioration and death. Thrombolysis was used in one patient, with suspected embolic events following his treatment. In the remaining two patients, medical management with chronic anticoagulation was successful in reducing the size of the thrombus.