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Updated: Aug 16, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Acute Bilateral Internal Carotid Occlusion from Embolization of Left Atrial Thrombus During Transesophageal
Syed Saad Mahmood1, Sunil Manjila2, Gagandeep Singh3
1Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Background And Purpose:
Transesophageal echocardiography (TEE) is a relatively safe imaging modality used to visualize intracardiac thrombus.
Summary Of Case:
We report on a unique, fatal complication during TEE of embolization of a pre-existing "smoking" left atrial thrombus causing acute bilateral internal carotid occlusion, confirmed on angiogram.
Conclusions:
Patients with history of lung pathology, such as COPD, who experience retching and cough during transesophageal echocardiography may be more susceptible to embolization of pre-existing thrombi. A need exists to risk stratify such patients.
