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Left atrial appendage occlusion device-related thrombus: a case report and review of the literature

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Abstract

A 75-year-old male with persistent atrial fibrillation underwent implantation of a left atrial occlusion device. After 6 weeks, a scheduled trans-esophageal echocardiogram showed a 1.1-cm × 1.1-cm mass within the occluded left atrial appendage, suspected to be thrombus. He was continued on warfarin for an additional 6 weeks and a repeat trans-esophageal echocardiogram showed obliteration of the left atrial appendage. This report describes an uncommon observation detected at scheduled follow up by trans-esophageal echocardiogram, which sheds some light on the mechanism by which this device “matures” after it is implanted inside the left atrial appendage.

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Fig. 1
Fig. 2

Abbreviations

TEE:

Trans-esophageal echocardiogram

LAA:

Left atrial appendage

TIA:

Transient ischaemic attack

References

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    Stoddard MF, Dawkins PR, Prince CR, et al. Left atrial appendage thrombus is not uncommon in patients with acute atrial fibrillation and a recent embolic event: a transesophageal echocardiographic study. J Am Coll Cardiol. 1995;25:452–9.

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Conflict of interest

We report no conflict of interest for the physicians involved in preparing this manuscript.

Author information

Correspondence to Wael Elabbassi.

Electronic supplementary material

Below are the links to the electronic supplementary material.

Video 1. Zoom at 94°. Space-occupying mass behind the barbs of the WATCHMAN device implanted inside the left atrial appendage (AVI 9204 kb)

Video 2. Modified left atrial view showing the left ventricular outflow tract, aortic valve and part of the left atrial appendage with the clot sealed inside (AVI 10328 kb)

Video 1. Zoom at 94°. Space-occupying mass behind the barbs of the WATCHMAN device implanted inside the left atrial appendage (AVI 9204 kb)

Video 2. Modified left atrial view showing the left ventricular outflow tract, aortic valve and part of the left atrial appendage with the clot sealed inside (AVI 10328 kb)

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Chowdhury, M.A., Elabbassi, W. & Al Nooryani, A. Left atrial appendage occlusion device-related thrombus: a case report and review of the literature. J Echocardiogr 10, 65–66 (2012). https://doi.org/10.1007/s12574-012-0115-3

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Keywords

  • Watchman
  • Left atrial appendage occlusion
  • Device-related thrombus
  • Atrial fibrillation