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Thrombus‐in‐Transit Following Watchman Device Implantation
Author(s) -
Wallenborn Julia,
Weidemann Frank,
Lengenfelder Björn,
Ritter Oliver,
Voelker Wolfram
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13172
Subject(s) - medicine , thrombus , contraindication , tamponade , atrial fibrillation , pulmonary embolism , cardiology , surgery , cardiac tamponade , thrombosis , deep vein , interatrial septum , venous thrombosis , left atrium , alternative medicine , pathology
Thrombus‐in‐transit crossing an interatrial communication is a rare but potentially serious clinical condition, which has so far not been described after implantation of left atrial appendage ( LAA ) closure devices. Here, we describe the case of a 76‐year‐old woman with permanent atrial fibrillation and contraindication for oral anticoagulation therapy, who developed pericardial tamponade and acute pulmonary embolism with visible thrombus‐in‐transit formation following LAA closure. Most likely manipulation of the Watchman device in the LAA during two failed attempts in device positioning led to pericardial tamponade and venous puncture, manual compression after completion of the procedure and further immobilization resulted in deep vein thrombosis with consecutive pulmonary embolism and thrombus‐in‐transit formation. This case highlights the value of echocardiography after LAA closure.