Abstract
CASE SUMMARY: We present a case of a young patient with a history of recurrent venous thromboembolism, stroke status post fibrinolysis, and titin-related dilated cardiomyopathy who developed cardiogenic shock in the setting of decompensated heart failure and concomitant large left ventricular thrombus comprising ∼75% of the cavity. Her shock was managed medically as she was evaluated for surgical heart failure therapies. The patient underwent a combined heart-lung transplant and was discharged after an uneventful postoperative course. TAKE-HOME MESSAGES: This case demonstrates that concomitant end-stage heart failure, large intracardiac thrombus, and severe pulmonary hypertension can be managed successfully with combined heart-lung transplantation.