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KMID : 0390620160240010060
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Journal of Cardiovascular Ultrasound
2016 Volume.24 No. 1 p.60 ~ p.63
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Heart within a Heart
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Tarun Jain
Jainil Shah
Sunay Shah
Shalini Modi
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Abstract
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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.
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KEYWORD
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Atrial fibrillation , Left atrial appendage , Transcatheter occlusion device
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