We describe the case of a 60-year-old female who presented with a non-ST elevation myocardial infarction 3 months following placement of a non-pulsatile left ventricular assist device (LVAD). Aortic root angiography not only revealed extensive aortic root thrombosis and left main thrombotic obstruction, but also vividly demonstrated the causative mechanism. To our knowledge, this rarely described mechanism of LVAD thrombosis has not been reported as clearly as this case illustrates.