Successful treatment of left atrial disk thrombus on an Amplatzer atrial septal defect occluder with abciximab and heparin.
Acute device thrombosis is a rare but important complication after transcatheter atrial septal defect closure. In this case a mobile thrombus was noted on the left side of an Amplatzer atrial septal occluder after device release in a 12 year old boy with an uncomplicated atrial septal defect. The thrombus was successfully treated with an infusion of heparin and the glycoprotein IIa/IIIb receptor antagonist abciximab. Transoesophageal ultrasound performed the following day showed complete resolution of the clot. There are no reports to guide treatment of acute thrombosis in this setting. This combination of treatments was effective without complication in this case.
Willcoxson
F E
FE
Yorkshire Heart Centre, E Floor, Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. fiona.willcoxson@btopenworld.com
Thomson
J D R
JD
Gibbs
J L
JL
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D021721:Balloon Occlusion / Q000009:adverse effects*; D002648:Child; D004868:Equipment Failure; D006325:Heart Atria; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D013927:Thrombosis / Q000188:drug therapy*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D006493:Heparin; D000077284:Abciximab