Open AccessThree-dimensional transesophageal echocardiography demonstration of left atrial appendage echocontrast regression after 6 months therapy with dabigatran and not with warfarin
Author(s) -
Domenico Vestito,
Delia Desantis,
Paolo Colonna
Publication year - 2016
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/2211-4122.183751
Subject(s) - medicine , warfarin , atrial fibrillation , dabigatran , thrombus , cardiology , appendage , cardioversion , atrial appendage , radiology , sinus rhythm , anatomy
While warfarin therapy is efficacious in treating left atrial (LA) thrombus formation in patients with nonvalvular atrial fibrillation (AF), it does not affect red cell aggregation in vitro or LA spontaneous echo-contrast in patients. In this patient with left ventricular (LV) dysfunction secondary to AF, we observed the disappearance of dense echo-contrast in the atrial appendage after therapy with dabigatran and not with well-controlled warfarin. This allowed us to analyze accurately the appendage with three-dimensional (3D) transesophageal echocardiography (TEE) excluding thrombi and to perform electrical cardioversion to obtain a significant improvement of LV function. This case demonstrates the capability of dabigatran and not of warfarin in reducing the intense spontaneous echocontrast in atrial appendage and the ability of 3D TEE in analyzing accurately the appendage, excluding thrombi to safely perform cardioversion.