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Background  Valve thrombosis – either biological or mechanical – is proved to increase patient’s morbidity and mortality. No consensus exist on the best management in such cases.    Case presentation  We report the case of a 69-year-old man presenting with a late thrombosis of a transcatheter aortic valve who was medically managed until he acutely worsened, developing myocardial ischemia and cardiogenic shock.    Conclusion  This unlucky case raises a word of caution about the safety of a reactive management.

Late thrombosis of a Transcatheter aortic valve: the border between a proactive and reactive management