title: Medical management of connector pin thrombosis with the Amplatzer cardiac plug left atrial closure device.
abstract: Transcatheter closure of the left atrial appendage with the Amplatzer™ cardiac plug device and double antiplatelet treatment for 3 mo has become an alternative treatment for patients with atrial fibrillation at high embolism risk and contraindications for chronic oral anticoagulation. The inadequate implantation of the left atrial appendage closure device and the discontinuation of double antiplatelet therapy are well-known as factors related to device thrombosis. Nevertheless, device thrombosis after adequate implantation requiring surgical treatment or restarting chronic oral anticoagulation has been reported and can reach 15% of patients. The connector pin thrombosis of the Amplatzer™ cardiac plug, despite a good adherence to antiplatelet treatment, has been recently described as a potential mechanism for device thrombosis. Our clinical case reports the management of this condition for the first time, showing that the early detection of thrombotic complications by transesophageal echocardiography permits solving this serious complication with medical treatment only.
authors.affiliation: Diego Fernández-Rodríguez, Luca Vannini, Victoria Martín-Yuste, Salvatore Brugaletta, Rocío Robles, Ander Regueiro, Mónica Masotti, Manel Sabaté, Department of Cardiology, Thorax Institute, Hospital Clínic, University of Barcelona, IDIBAPS, 08036 Barcelona, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Fernández-Rodríguez
authors.forename: Luca
authors.initials: L
authors.lastname: Vannini
authors.forename: Victoria
authors.initials: V
authors.lastname: Martín-Yuste
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Rocío
authors.initials: R
authors.lastname: Robles
authors.forename: Ander
authors.initials: A
authors.lastname: Regueiro
authors.forename: Mónica
authors.initials: M
authors.lastname: Masotti
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
keywords: Amplatzer cardiac plug; Atrial fibrillation; Device thrombosis; Left atrial appendage closure; Oral anticoagulation