Journal of Cardiovascular Ultrasound  2016;24(1):60-63

doi:10.4250/jcu.2016.24.1.60

Heart within a Heart.

Tarun JAIN 1 ; Jainil SHAH ; Sunay SHAH ; Shalini MODI

Affiliations

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Keywords

Atrial fibrillation; Left atrial appendage; Transcatheter occlusion device

Country

Republic of Korea

Language

English

Abstract

Device based closure of the left atrial appendage (LAA) has emerged as a viable approach for stroke prevention in atrial fibrillation (AF) patients with contraindications to chronic oral anticoagulation. One of the most feared complications is device related thrombus formation. We present a 66-year-old male with chronic AF who developed a life-threatening intracranial bleed on oral anti-coagulation. He subsequently underwent LAA closure using an Amplatzer muscular ventricular septal defect closure device for stroke prevention. However, he was found to have a large thrombus attached to the device a year later. We present a review of the various LAA closure devices, importance of periodic surveillance via echocardiography and management options to prevent this complication. Also, the case highlights the importance of contrast-enhance echocardiography in diagnosis of LAA closure device thrombus.