Acute Formation of Thrombus on a Left Atrial Appendage Occlusion Device Immediately After Detachment

Manongi, Ngoda; Volodarskiy, Alexander; Goldbarg, Seth

doi:10.1016/j.jaccas.2023.101933

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…However, data from PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) and PREVAIL (Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy) trials revealed that a significant proportion of DRTs were detected beyond the one-year mark [ 1 ]. In a meta-analysis comprising 10,154 patients across 66 studies who underwent post-LAAO surveillance imaging, the pooled incidence of DRT was found to be 3.8% and associated with increased risk of ischemic events [ 2 ]; however, immediate clot formation after the Watchman device deployment is an exceedingly rare occurrence, with only several cases documented thus far [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Unforeseen and Immediate: A Case of a Post-Watchman Device-Related Thrombus

Sethi,

Stolear,

Dulgher

et al. 2024

Cureus

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Atrial fibrillation (AFib) is recognized as a risk factor linked to arterial thromboembolism stemming from blood clot formation in the left atrium, associated with increased morbidity and mortality. Most of these thrombi originate in the left atrial appendage (LAA). Oral anticoagulation (OAC) therapy can help mitigate this risk. LAA occlusion (LAAO) has emerged as an option for patients who cannot safely tolerate long-term OAC. Watchman is one of the commonly used devices with a favorable safety profile demonstrated in numerous studies. One of the most concerning complications of LAAO is device-related thrombus (DRT), which may form on the atrial side of the device and potentially lead to embolization. We present a rare case of immediate DRT formation following the deployment of a Watchman device in a 78-year-old male with persistent AFib. Despite appropriate periprocedural management, a thrombus was observed immediately post implantation. This case emphasizes the need for vigilant surveillance, prompt diagnosis, and therapeutic intervention to manage such complications. The patient was successfully managed with a heparin drip, leading to thrombus resolution. This report underscores the complexities of managing DRT and the importance of ongoing research to optimize outcomes for patients undergoing LAAO.

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Section: Discussionmentioning

confidence: 99%

Unforeseen and Immediate: A Case of a Post-Watchman Device-Related Thrombus

Sethi,

Stolear,

Dulgher

et al. 2024

Cureus

View full text Add to dashboard Cite

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Acute thrombus formation on the delivery sheath during left atrial appendage occlusion: Case reports with placement of cerebral protection devices

Yu,

Du,

Zhao

et al. 2023

Clinical Case Reports

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Key Clinical MessageAcute thrombus formation on the delivery sheath is rare condition during percutaneous left atrial appendage occlusion. We presented two cases that transesophageal echocardiography (TEE) showed a floating thrombus attached to the tip of delivery sheath during the procedure. Cerebral embolic protection devices were used to prevent neurological events after thrombus was detected. The neurological function was not impaired post‐procedure.

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Acute Formation of Thrombus on a Left Atrial Appendage Occlusion Device Immediately After Detachment

Cited by 2 publications

References 9 publications

Unforeseen and Immediate: A Case of a Post-Watchman Device-Related Thrombus

Unforeseen and Immediate: A Case of a Post-Watchman Device-Related Thrombus

Acute thrombus formation on the delivery sheath during left atrial appendage occlusion: Case reports with placement of cerebral protection devices

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