title: Heart within a Heart.
abstract: Device based closure of the left atrial appendage (LAA) has emerged as a viable approach for stroke prevention in atrial fibrillation (AF) patients with contraindications to chronic oral anticoagulation. One of the most feared complications is device related thrombus formation. We present a 66-year-old male with chronic AF who developed a life-threatening intracranial bleed on oral anti-coagulation. He subsequently underwent LAA closure using an Amplatzer muscular ventricular septal defect closure device for stroke prevention. However, he was found to have a large thrombus attached to the device a year later. We present a review of the various LAA closure devices, importance of periodic surveillance via echocardiography and management options to prevent this complication. Also, the case highlights the importance of contrast-enhance echocardiography in diagnosis of LAA closure device thrombus.
authors.affiliation: Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Tarun
authors.initials: T
authors.lastname: Jain
authors.affiliation: Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Jainil
authors.initials: J
authors.lastname: Shah
authors.affiliation: Department of Cardiology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Sunay
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Cardiology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Shalini
authors.initials: S
authors.lastname: Modi
keywords: Atrial fibrillation; Left atrial appendage; Transcatheter occlusion device