Percutaneous left atrial appendage occlusion following successful treatment of large bi-atrial thrombi in a patient with atrial fibrillation: a case report

Ng, Kim Fong ORCID: 0000-0002-5306-2622, Calvert, Peter, Khalatbari, Afshin, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Velavan, Periaswamy and Gupta, Dhiraj (2023) Percutaneous left atrial appendage occlusion following successful treatment of large bi-atrial thrombi in a patient with atrial fibrillation: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS, 7 (4). ytad165-.

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Official URL: http://dx.doi.org/10.1093/ehjcr/ytad165

Abstract

<h4>Background</h4>Atrial fibrillation (AF) is a well-established risk factor for intracardiac thrombosis. Left atrial appendage occlusion (LAAO) is emerging as a viable alternative to oral anticoagulation (OAC) for high-risk AF patients who are contraindicated to long-term OAC.<h4>Case summary</h4>A 74-year-old man with a history of permanent AF and subdural haemorrhage on warfarin therapy was referred to our facility for further management. Cardiac CT imaging revealed large bi-atrial thrombi for which apixaban therapy was initiated. Serial imaging over nine months showed gradual shrinkage and then resolution of the thrombi. In line with the patient's preference to avoid life-long OAC, he received LAAO using an Amplatzer™ Amulet™ device. Follow-up transoesophageal echocardiography showed a well-seated device with no leak and no thrombus.<h4>Discussion</h4>We discussed the key issues surrounding management of bi-atrial thrombi and the decision to perform LAAO in these circumstances, relying on shared decision making and multi-disciplinary team input.

Item Type:	Article
Uncontrolled Keywords:	Bi-atrial thrombi, Atrial fibrillation, Left atrial appendage occlusion, Anticoagulation, Apixaban, Case report
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	12 Oct 2023 15:47
Last Modified:	12 Oct 2023 15:48
DOI:	10.1093/ehjcr/ytad165
Open Access URL:	https://doi.org/10.1093/ehjcr/ytad165
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173659