Related Experiment Video
Updated: Jul 16, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Removal of a left atrial thrombus adherent to a patent foramen ovale occluder
Peter Krieg1, Harald Lapp, Klaus Pethig
1Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany. peter.krieg@med.uni-jena.de
Insights
A patent foramen ovale closure device was removed due to thrombus formation, preventing further thromboembolic events. This case highlights potential complications after PFO closure, emphasizing careful monitoring.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Patent foramen ovale (PFO) closure is a common procedure to prevent paradoxical embolism.
- Complications, though rare, can occur following device implantation.
Observation:
- A 62-year-old male developed bilateral lower leg artery thromboembolic occlusion 8 months post-PFO closure with an Amplatzer device.
- The patient subsequently experienced acute myocardial ischemia and a new cerebral ischemic lesion.
- Echocardiography revealed a thrombus attached to the PFO closure device in the left atrium.
Findings:
- Thromboembolic occlusion of the right coronary artery was confirmed via left heart catheterization.
- Successful emergency removal of the PFO device and left atrial thrombus was performed.
- Coronary artery bypass grafting was completed, and the septal defect was closed.
Implications:
- This case underscores the risk of late-onset device-related thrombosis after PFO closure.
- Prompt diagnosis and intervention are crucial for managing such severe thromboembolic complications.
- Further research into long-term device surveillance and anticoagulation strategies may be warranted.
Abstract:
A 62-year-old man presented with bilateral thromboembolic occlusion of the lower leg arteries 8 months after closure of a patent foramen ovale with an Amplatzer patent-foramen-ovale occluder (AGA Medical Corporation, Plymouth, MN). Then he developed an acute myocardial ischemia. A left heart catheter revealed thromboembolic occlusion of the right coronary artery, and echocardiography demonstrated a thrombus attached to the device within the left atrium. Cerebral computer tomography showed a new ischemic lesion. In an emergency procedure, the device and the left atrial thrombus were removed, the septal defect was closed, and a coronary artery bypass grafting was performed. The patient was discharged from the hospital in stable condition.
