Published online Oct 26, 2013. doi: 10.4330/wjc.v5.i10.391
Revised: September 9, 2013
Accepted: September 18, 2013
Published online: October 26, 2013
Processing time: 151 Days and 15.3 Hours
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.
Core tip: Percutaneous closure of the left atrial appendage has become an alternative treatment for patients with atrial fibrillation and with contraindications for chronic oral anticoagulation. Recently, the first case of connector pin thrombosis of the Amplatzer™ cardiac plug device for percutaneous left atrial appendage closure was described. Our work describes the management of this serious problem for the first time.