<p>In patients with left ventricular assist device (LVAD), concomitant mechanical valve is contraindicated for fear of thromboembolism. It is recommended that mechanical valves be replaced with biological valves or that mechanical valves be permanently closed when LVAD is indicated. Recently, a novel mechanical valve has proven safety in terms of valve thrombosis or thromboembolism in patients with valvular disease, though limited data is available regarding the performance of the valve in patients receiving LVAD therapy. In this report, we describe a case of successful bridge with extracorporeal LVAD to durable LVAD therapy without thromboembolism for postoperative cardiogenic shock after aortic root replacement using an On-X mechanical valve.</p> Graphical abstract <p></p> <p>A successful bridge was performed from extracorporeal LVAD to implantable LVAD in a patient with a previous mechanical aortic valve without any thromboembolic events. The absence of thrombus on the mechanical valve was confirmed with enhanced CT at 1-year after surgery</p>