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Thromboembolism after WATCHMAN TM in a clopidogrel non‐responder: A case for concern?
Author(s) -
Venkataraman Ganesh,
Bliden Kevin P.,
Tantry Udaya S.,
Gurbel Paul A.
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27402
Subject(s) - medicine , clopidogrel , aspirin , atrial fibrillation , thrombus , cardiology , warfarin , stroke (engine) , embolic stroke , ischemic stroke , mechanical engineering , ischemia , engineering
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN TM left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non‐valvular AF. Here, we present a case of a patient with device‐related thrombus who suffered a TE event two months after WATCHMAN TM LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non‐responder to clopidogrel therapy. We discuss the potential role of platelet function testing to prevent device‐related thrombi.