[Interventional left atrial appendage closure in a patient with GAVE syndrome]

History and findings | A 56-year-old female with a gastric antral vascular ectasia (GAVE) suffered from recurrent episodes of upper gastrointestinal bleeding. Because of a history of a permanent atrial fibrillation (CHA₂DS₂-VASc score 3 points) an oral anticoagulation therapy with phenprocoumon was carried out which even worsened the bleeding frequency and intensity. A change of medication to low-molecular weight heparin did not lead to success. The frequent periods in hospital limited the patient's quality of life. Therapy and course | Two months after the initial diagnosis of the GAVE syndrome and after 5 hospital admissions together with several argon plasma coagulations an AmplatzerTM Cardiac Plug 2 was successfully implanted. With the postinterventional dual antiplatelet therapy with ASA and clopidogrel instead of an oral anticoagulation the bleedings stopped. Conclusion | The interventional left atrial appendage closure appears to be a feasible and safe alternative to oral anticoagulation in patients with a GAVE syndrome and non-valvular atrial fibrillation.