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Case Reports
. 2022 Nov 16;4(22):1475-1479.
doi: 10.1016/j.jaccas.2022.08.046.

Acute Left Atrial Appendage Thrombus Formation During Transcatheter Mitral Valve Edge-to-Edge Repair

Vikram Sharma  1 , Phillip A Horwitz  1 , James D Rossen  1 , Ramzi N El Accaoui  1
Affiliations
Case Reports

Acute Left Atrial Appendage Thrombus Formation During Transcatheter Mitral Valve Edge-to-Edge Repair

Vikram Sharma et al. JACC Case Rep. .

Abstract

We present a case of a 75-year-old man who developed an acute left atrial appendage thrombus immediately following mitral valve transcatheter edge to edge repair despite adequate intraprocedural anticoagulation. The patient was managed with enoxaparin to warfarin bridging with no obvious thromboembolic events on follow-up. Attention to anticoagulation is important to reduce thromboembolic risk during mitral valve transcatheter edge to edge repair. (Level of Difficulty: Intermediate.).

Keywords: ACT, activated clotting time; INR, international normalized ratio; LAA, left atrial appendage; NYHA, New York Heart Association; TEE, transesophageal echocardiogram; TEER, transcatheter edge to edge repair; anticoagulation; left atrial appendage thrombus; mitral regurgitation; transcatheter mitral valve edge to edge repair.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Preprocedural Transesophageal Echocardiogram Showing No Evidence of Left Atrial Appendage Thrombus Arrows point to the left atrial appendage. (Left) Left atrial appendage at 56°; (right) left atrial appendage at 138°, showing absence of a thrombus in 2 orthogonal planes. TEER = transcatheter edge to edge repair
Figure 2
Figure 2
Spontaneous Echo-Contrast in the Left Atrium and LAA Immediately After Mitral Valve TEER LAA = left atrial appendage; TEER = transcatheter edge to edge repair
Figure 3
Figure 3
Well-Formed Thrombus in the LAA Within Minutes of Mitral Valve TEER Abbreviations as in Figure 2.
See this image and copyright information in PMC

References

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