Key result
Early medical therapy successfully resolves connector pin thrombosis on the Amplatzer cardiac plug.
Why the study?
Device thrombosis after adequate implantation of the Amplatzer cardiac plug can occur despite antiplatelet therapy and may require surgical treatment or chronic oral anticoagulation, but management of connector pin thrombosis has not been described.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
May allow conservative management of Amplatzer connector pin thrombosis; hypothesis-generating and requires confirmation in larger series.
Transcatheter closure of the left atrial appendage with the Amplatzer™ cardiac plug device and double antiplatelet treatment for 3 mo has become an alternative treatment for patients with atrial fibrillation at high embolism risk and contraindications for chronic oral anticoagulation. The inadequate implantation of the left atrial appendage closure device and the discontinuation of double antiplatelet therapy are well-known as factors related to device thrombosis. Nevertheless, device thrombosis after adequate implantation requiring surgical treatment or restarting chronic oral anticoagulation has been reported and can reach 15% of patients. The connector pin thrombosis of the Amplatzer™ cardiac plug, despite a good adherence to antiplatelet treatment, has been recently described as a potential mechanism for device thrombosis. Our clinical case reports the management of this condition for the first time, showing that the early detection of thrombotic complications by transesophageal echocardiography permits solving this serious complication with medical treatment only.
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Fernández-Rodríguez et al. (2013) conducted a case report in Connector pin thrombosis of the Amplatzer cardiac plug device (n=1). Medical treatment guided by transesophageal echocardiography was evaluated on Resolution of thrombotic complication. Medical treatment only, following early detection by transesophageal echocardiography, successfully resolved connector pin thrombosis of the Amplatzer cardiac plug.
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