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Updated: Jun 13, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Progressive Giant Left Atrial Appendage Thrombus After Aborted Appendage Occlusion Despite Anticoagulation
Ryudo Kawahara1, Hideo Tokuyama1, Shota Yamanaka2
1Department of Cardiovascular Medicine, Kawaguchi Cardiovascular and Respiratory Hospital, Kawaguchi, Japan.
Background:
Thrombus formation after successful left atrial appendage occlusion (LAAO) has been well described; however, the clinical course after aborted LAAO remains poorly characterized.
Case Summary:
An 84-year-old man with atrial fibrillation and a history of cardioembolic events underwent an attempted LAAO procedure that was aborted because of unfavorable appendage anatomy. A small thrombus suspected on transthoracic echocardiography the day after the procedure progressively enlarged over 3 months and ultimately required surgical thrombus removal and left atrial appendage resection.
Discussion:
Thrombus formation after an aborted LAAO attempt is not routinely observed, particularly under therapeutic anticoagulation. In this case, temporary interruption of anticoagulation, local endothelial disruption, blood stasis, and a possible prothrombotic milieu may have contributed.
Take-Home Messages:
Progressive native left atrial appendage thrombus may occur after aborted LAAO despite anticoagulation therapy. Careful postprocedural imaging surveillance should be considered in high-risk patients.
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