title: Device-related thrombus overlying a left-atrial occlusion device implanted for persistent spontaneous echo contrast despite prolonged oral anticoagulation therapy.
abstract: A 75-year-old woman with a history of atrial fibrillation, severe biatrial enlargement, persistent dense spontaneous echo contrast in the left atrium and left-atrial appendage on appropriate oral anticoagulant therapy underwent implantation of the left-atrial occlusion device to decrease her risk of thromboembolic stroke. Six weeks later, a scheduled transesophageal echocardiography showed a partially mobile mass (4.1 × 2.1 cm) overlying the atrial surface of the device: a suspected thrombus. This report highlights the importance of follow-up examination and the limitation of this treatment modality among patients with persistent atrial fibrillation, large left atria and dense spontaneous echo contrast.
authors.affiliation: Department of Cardiology, Al-Qassimi Hospital, Sharjah, United Arab Emirates. welabbassi@yahoo.com
authors.forename: Wael
authors.initials: W
authors.lastname: Elabbassi
authors.forename: Ahmed Najeeb
authors.initials: AN
authors.lastname: Osman
authors.forename: Mohammed Andaleeb
authors.initials: MA
authors.lastname: Chowdhury
authors.forename: Arif Al
authors.initials: AA
authors.lastname: Nooryani
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000000981:diagnostic imaging; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D057505:Embolic Protection Devices / Q000009:adverse effects*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D055989:Septal Occluder Device / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants