Key result
Balloon sizing during PFO closure triggers spontaneous left atrial thrombus, underscoring periprocedural echocardiography monitoring.
Why the study?
Spontaneous left atrial thrombus formation during percutaneous PFO closure despite antithrombotic therapy is a potential procedural complication requiring awareness.
Case Report (n=1)
Spontaneous LA thrombus during PFO balloon sizing warrants periprocedural vigilance; this case leaves open whether routine echo monitoring improves safety.
A 52-year-old male smoker suffered a left-sided stroke. Bubble contrast echocardiography demonstrated an aneurysmal atrial septum and patent foramen ovale (PFO). The patient was referred for percutaneous closure of his PFO to reduce his risk of further stroke. Despite dual antiplatelet therapy and pre-procedural heparin, he developed a spontaneous thrombus during balloon sizing of the defect identified by transoesophageal echocardiography. The balloon was immediately withdrawn to the right side and removed. Periprocedural echocardiography using either transoesophageal or intracardiac echo is essential to monitor for this potential procedural complication of percutaneous PFO closure.
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Hudsmith et al. (2008) conducted a case report in Patent foramen ovale with prior stroke (n=1). Percutaneous patent foramen ovale closure was evaluated. Percutaneous patent foramen ovale closure in a 52-year-old male was complicated by spontaneous left atrial thrombus formation during balloon sizing, highlighting the need for periprocedural echo.
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