Acute Left Atrial Appendage Thrombus Formation During Transcatheter Mitral Valve Edge-to-Edge Repair

Vikram Sharma; Phillip A Horwitz; James D Rossen; Ramzi N El Accaoui

doi:10.1016/j.jaccas.2022.08.046

Acute Left Atrial Appendage Thrombus Formation During Transcatheter Mitral Valve Edge-to-Edge Repair

JACC Case Rep. 2022 Nov 16;4(22):1475-1479. doi: 10.1016/j.jaccas.2022.08.046.

Authors

Vikram Sharma¹, Phillip A Horwitz¹, James D Rossen¹, Ramzi N El Accaoui¹

Affiliation

¹ Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.

Abstract

We present a case of a 75-year-old man who developed an acute left atrial appendage thrombus immediately following mitral valve transcatheter edge to edge repair despite adequate intraprocedural anticoagulation. The patient was managed with enoxaparin to warfarin bridging with no obvious thromboembolic events on follow-up. Attention to anticoagulation is important to reduce thromboembolic risk during mitral valve transcatheter edge to edge repair. (Level of Difficulty: Intermediate.).

Keywords: ACT, activated clotting time; INR, international normalized ratio; LAA, left atrial appendage; NYHA, New York Heart Association; TEE, transesophageal echocardiogram; TEER, transcatheter edge to edge repair; anticoagulation; left atrial appendage thrombus; mitral regurgitation; transcatheter mitral valve edge to edge repair.

Publication types

Case Reports