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Updated: Jan 23, 2026

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation
06:25

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Published on: March 15, 2020

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Sudden floating thrombus formation on the delivery cable before Amplatzer-Amulet device deployment during left atrial

Giuseppe Talanas1, Giuseppe D Sanna1, Michele Portoghese2

  • 1Clinical and Interventional Cardiology Unit, Sassari University Hospital, Sassari, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 15, 2019
PubMed

Anticoagulation is of paramount importance during left atrial appendage occlusion procedure (LAAOP) to prevent periprocedural stroke. We present the case of a 66-year-old male patient who was scheduled to undergo LAAOP because of a prior intracranial bleeding. After transesophageal echocardiography-guided transseptal puncture, intravenous heparin 5,000 IUs were administered obtaining an ACT greater than 300 s. We planned to implant an Amplatzer-Amulet 25 mm LAA occluder through the dedicated 12F delivery sheath. After starting the tug test, TEE suddenly showed a floating thrombus whose proximal part was connected to the delivery cable. Because transesophageal echocardiography showed a good position of the device, we decided to release it and to quickly retrieve as a unit into the right atrium both the delivery cable with attached thrombus and the delivery sheath. We discuss about periprocedural anticoagulation dosing and monitoring and the importance to have specific studies in the setting of LAAOP.

Keywords:
Amplatzer-Amulet delivery cableleft atrial appendage occlusionthrombus

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