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Device-Related Thrombus After Left Atrial Appendage Closure

Philippe Garot1, Bertrand Cormier1, Jérôme Horvilleur1

  • 1Hôpital Privé Jacques Cartier, Institut Cardiovasculaire Paris Sud - Ramsay Générale de Santé Massy, France.

Interventional Cardiology (London, England)
|March 13, 2019
PubMed

Insights

Left atrial appendage closure (LAAC) is effective for AF patients, but device-related thrombus (DRT) poses a stroke risk. Management strategies for DRT, especially in patients unable to take oral anticoagulants, require careful consideration.

Area of Science:

  • Cardiology
  • Medical Devices
  • Thrombosis

Background:

  • Left atrial appendage closure (LAAC) is an alternative to oral anticoagulants for atrial fibrillation (AF) patients.
  • Concerns exist regarding late complications, particularly device-related thrombus (DRT), after LAAC.
  • DRT is linked to an elevated stroke risk.

Purpose of the Study:

  • To discuss the incidence, risk factors, and temporal patterns of DRT following LAAC.
  • To explore potential management strategies for DRT.
  • To address the specific challenges in managing DRT in patients with contraindications to oral anticoagulants.

Main Methods:

  • Review of existing literature on LAAC and DRT.
  • Analysis of incidence, risk factors, and timing of DRT.
  • Discussion of management approaches and individualized treatment decisions.

Main Results:

  • DRT is a recognized late complication of LAAC.
  • Specific risk factors and time courses for DRT development are identified.
  • Management strategies, especially for anticoagulation-contraindicated patients, are still under investigation.

Conclusions:

  • LAAC is a viable option for AF, but DRT risk necessitates vigilance.
  • Individualized, multidisciplinary assessment is crucial for managing DRT, particularly in high-risk patients.
  • Further research is needed to optimize DRT management strategies.

Keywords:
Complicationsdevice-related thrombusleft atrial appendage closureoutcomesstrokethrombus

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