Pulmonary vein thrombus is a rare but potential complication of mitral valve TEER that can be successfully managed with direct oral anticoagulants like apixaban.
Pulmonary vein thrombus after TEER may warrant pre-procedural screening before Watchman; leaves open incidence and significance in larger cohorts.
A 76-year-old female with a complicated medical history presented for Watchman (Boston Scientific) placement 2 months after mitral valve transcatheter edge-to-edge repair (TEER). Preoperative workup before Watchman placement confirmed the presence of a thrombus in the left superior pulmonary vein. Post-procedure mitral valve TEER transesophageal echocardiogram showed no thrombus in the left atrium appendage or pulmonary veins. We believe the thrombus in the left superior pulmonary vein occurred secondarily due to epithelium damage during the mitral valve TEER.
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Rana et al. (2024) studied this question.
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