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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Acute Left Atrial Appendage Thrombus Formation During Transcatheter Mitral Valve Edge-to-Edge Repair
Vikram Sharma1, Phillip A Horwitz1, James D Rossen1
1Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
JACC. Case Reports
|November 29, 2022
Summary
A patient developed a left atrial appendage thrombus after mitral valve repair, despite anticoagulation. Management with enoxaparin and warfarin bridging prevented further events, highlighting anticoagulation
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure for mitral valve disease.
- Atrial appendage thrombus formation is a potential complication, carrying thromboembolic risks.
Observation:
- A 75-year-old male developed an acute left atrial appendage thrombus immediately post-mitral valve TEER.
- Adequate intraprocedural anticoagulation was administered during the procedure.
Findings:
- The patient was successfully managed with a bridging anticoagulation strategy using enoxaparin and warfarin.
- No further thromboembolic events were observed during follow-up.
Implications:
- This case underscores the importance of vigilant anticoagulation management in patients undergoing mitral valve TEER.
- Optimizing anticoagulation protocols may be crucial for mitigating thromboembolic risk following TEER procedures.
Keywords:
ACT, activated clotting timeINR, international normalized ratioLAA, left atrial appendageNYHA, New York Heart AssociationTEE, transesophageal echocardiogramTEER, transcatheter edge to edge repairanticoagulationleft atrial appendage thrombusmitral regurgitationtranscatheter mitral valve edge to edge repair
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