title: Embolic stroke due to a left atrial thrombus two years after placement of an atrial septal defect closure device.
abstract: A 29-year-old woman who had undergone closure of a secundum-type atrial septal defect using the Amplatzer device 2 years previously developed acute and progressive altered mentation. Initial clinical and imaging data confirmed the diagnosis of multiple cerebral, cerebellar and brain stem emboli, and infarcts. She was treated urgently with an intra-arterial thrombolytic agent with only minimal improvement. Transesophageal echocardiography revealed a large thrombus attached to the left atrial disc of the atrial septal defect occluder, which was the source of the emboli. In conclusion, this is the first reported case, to our knowledge, of disseminated cerebral emboli and infarctions as a late complication of transcatheter closure of a secundum-type atrial septal defect.
authors.affiliation: Department of Internal Medicine, Cardiology Division, Presbyterian Hospital of Dallas, Dallas, Texas, USA.
authors.forename: Aarti
authors.initials: A
authors.lastname: Raghu
authors.forename: Darryl
authors.initials: D
authors.lastname: Kawalsky
authors.forename: Mark
authors.initials: M
authors.lastname: Feldman
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures; D002544:Cerebral Infarction / Q000209:etiology; D017548:Echocardiography, Transesophageal; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation*; D004868:Equipment Failure; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D020521:Stroke / Q000209:etiology*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging