title: Spontaneous left atrial thrombus during patent foramen ovale closure.
abstract: A 52-year-old male smoker suffered a left-sided stroke. Bubble contrast echocardiography demonstrated an aneurysmal atrial septum and patent foramen ovale (PFO). The patient was referred for percutaneous closure of his PFO to reduce his risk of further stroke. Despite dual antiplatelet therapy and pre-procedural heparin, he developed a spontaneous thrombus during balloon sizing of the defect identified by transoesophageal echocardiography. The balloon was immediately withdrawn to the right side and removed. Periprocedural echocardiography using either transoesophageal or intracardiac echo is essential to monitor for this potential procedural complication of percutaneous PFO closure.
authors.affiliation: The Queen Elizabeth Hospital, Birmingham, UK. lucyhudsmith@hotmail.com
authors.forename: Lucy
authors.initials: L
authors.lastname: Hudsmith
authors.forename: Sara
authors.initials: S
authors.lastname: Thorne
authors.forename: Paul
authors.initials: P
authors.lastname: Clift
mesh_terms: D000925:Anticoagulants; D001241:Aspirin / Q000627:therapeutic use; D054087:Atrial Septum; D021721:Balloon Occlusion / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004452:Echocardiography / Q000379:methods; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D006322:Heart Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D006325:Heart Atria; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D020521:Stroke / Q000209:etiology / Q000628:therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D001241:Aspirin