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Updated: Aug 4, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Massive Device-Related Thrombus After LAA Occlusion: Intraoperative Insights Into Mechanism
Damir Vukomanovic1, Samuel Unzek2, Kashif Malik3
1Department of Internal Medicine, University of Arizona College of Medicine, Banner University Medical Center-Phoenix, Phoenix, Arizona, USA.
Insights
Left atrial appendage occlusion devices offer an alternative to oral anticoagulation. This case series suggests incomplete endothelialization may cause device-related thrombus formation.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis Research
Background:
- Left atrial appendage occlusion (LAAO) devices are an FDA-approved alternative for patients with contraindications to oral anticoagulation.
- Device-related thrombus (DRT) is a known complication following LAAO procedures.
- The precise mechanisms driving DRT formation remain incompletely understood.
Observation:
- This case series presents intraoperative imaging findings.
- The images reveal instances of incomplete endothelialization over the deployed LAAO devices.
- This observation provides potential insight into DRT development.
Findings:
- The authors propose a unifying mechanism for DRT.
- This mechanism links incomplete endothelialization to thrombus formation on LAAO devices.
- Intraoperative visualization supports this hypothesis.
Implications:
- Understanding the mechanism of DRT can inform device design and implantation techniques.
- Improved understanding may lead to strategies for reducing DRT risk.
- This research contributes to the safe and effective use of LAAO devices in clinical practice.
Abstract:
In patients with a contraindication to oral anticoagulation, the left atrial appendage occlusion devices are an approved alternative. Device-related thrombus is a recognized complication, but underlying mechanisms are incompletely understood. In this case series, the authors describe potentially the same mechanism of thrombosis with intraoperative images of incomplete endothelialization. (Level of Difficulty: Intermediate.).
