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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Closure Device-Related Thrombosis After Anticoagulation With Dabigatran in Patients Undergoing Percutaneous Left

Xiaoye Li1, Qinchun Jin2, Xiaochun Zhang2

  • 1Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China.

Frontiers in Pharmacology
|October 5, 2020
PubMed

Insights

Left atrial appendage closure (LAAC) prevents stroke in atrial fibrillation (AF) patients. Rare device-related thrombosis (DRT) occurred with dabigatran but resolved after switching to rivaroxaban or warfarin.

Area of Science:

  • Cardiology
  • Medical Devices
  • Thrombosis

Background:

  • Percutaneous left atrial appendage closure (LAAC) is a stroke prevention strategy for atrial fibrillation (AF) patients intolerant to long-term anticoagulation.
  • LAAC devices aim to reduce thromboembolic events in high-risk AF populations.

Observation:

  • Four rare cases of device-related thrombosis (DRT) were observed after successful LAAC procedures.
  • Patients received dabigatran anticoagulation post-procedure, and DRT was diagnosed via transesophageal echocardiogram (TEE) during follow-up.

Findings:

  • Thrombosis formed on the LAAC occluder device despite dabigatran therapy.
  • Switching anticoagulation from dabigatran to rivaroxaban or warfarin led to thrombosis regression within one month.

Implications:

  • These findings highlight a potential complication of LAAC with specific anticoagulants.
  • Alternative anticoagulation strategies may be necessary for managing DRT after LAAC.
  • Further research is warranted to optimize anticoagulation protocols post-LAAC to prevent DRT.

Keywords:
atrial fibrillationdabigatrandevice-related thrombosisleft atrial appendage closurenovel oral anticoagulation

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