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Updated: Mar 14, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Rare Right Atrial Thrombus Deferred Atrial Septal Defect Closure and Implantable Cardioverter-Defibrillator

Sachin Sapkota¹, Sandesh Murali¹, Kahtan Fadah¹

¹Texas Tech University Health Science Center El Paso, El Paso, Texas, USA.

JACC. Case Reports

|March 13, 2026

Summary

A rare right atrial thrombus was found in a patient undergoing atrial septal defect (ASD) closure. This unexpected finding highlights the importance of preprocedural imaging to prevent serious embolic events.

Keywords:

atrial septal defect echocardiography systolic heart failure thrombus

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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Area of Science:

Cardiology
Cardiovascular Imaging
Interventional Cardiology

Background:

Nonischemic cardiomyopathy and atrial septal defect (ASD) present unique clinical challenges.
Right atrial thrombi are uncommon, particularly in patients without atrial arrhythmias or implanted devices.
Percutaneous ASD closure and implantable cardioverter-defibrillator (ICD) placement are common procedures requiring careful preprocedural evaluation.

Purpose of the Study:

To report a rare case of right atrial thrombus discovered during preprocedural imaging for atrial septal defect (ASD) closure.
To emphasize the significance of preprocedural echocardiography in identifying unexpected cardiac masses.
To highlight the potential risks of embolic complications in patients with cardiac anomalies.

Main Methods:

A 47-year-old male patient with nonischemic cardiomyopathy and ASD was evaluated.
Transesophageal echocardiography (TEE) was performed prior to planned percutaneous ASD closure and ICD placement.
The patient was subsequently managed conservatively with warfarin anticoagulation.

Main Results:

Preprocedural TEE unexpectedly revealed a large right atrial thrombus.
Both planned procedures (ASD closure and ICD placement) were canceled due to the thrombus.
Conservative management with warfarin was initiated.

Conclusions:

This case represents the first reported instance of a right atrial thrombus detected during the workup for ASD closure.
The findings underscore the critical role of thorough preprocedural imaging to prevent potentially life-threatening embolic events.
Right atrial thrombus formation can occur even in the absence of typical risk factors like atrial arrhythmia or indwelling devices.