Multiple Thromboembolic Events from a Left Atrial Appendage Occlusion Device

Can J Cardiol. 2018 Mar;34(3):342.e13-342.e15. doi: 10.1016/j.cjca.2017.12.017. Epub 2017 Dec 27.

Abstract

Left atrial appendage occlusion devices are an alternative to oral anticoagulation in patients with nonvalvular atrial fibrillation who are at risk of ischemic stroke. Thromboprophylaxis after implantation is recommended, but the optimal regimen is unknown. We report a clinicopathologic case in which thrombus adherent to an incompletely endothelialized WATCHMAN device (Boston Scientific, Marlborough, MA) resulted in multiple thromboembolic events, contributing to a fatal outcome. This case illustrates uncertainties regarding the device's endothelialization process.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Atrial Appendage / surgery*
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / surgery*
  • Cardiac Catheterization / methods
  • Disease Progression
  • Echocardiography, Transesophageal / methods
  • Fatal Outcome
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / physiopathology
  • Humans
  • Prostheses and Implants / adverse effects*
  • Prosthesis Failure
  • Recurrence
  • Thromboembolism / diagnostic imaging
  • Thromboembolism / drug therapy
  • Thromboembolism / etiology*

Substances

  • Anticoagulants