Key result
Amplatzer Amulet achieves complete LAA occlusion and coumadin ridge mass exclusion at 2 years.
Why the study?
Mobile cardiac masses on the coumadin ridge are rare and carry significant embolic risk compounded by concurrent atrial fibrillation, while surgical excision may be prohibitive in patients with high bleeding risk.
Case Report (n=1)
This case report demonstrates the novel use of the Amplatzer Amulet's larger disc geometry to simultaneously occlude the left atrial appendage and exclude an adjacent mobile coumadin ridge mass in a patient with high bleeding risk.
Answers are grounded in this paper and cite their sources.
May enable single-device exclusion in select high-risk AF cases; hypothesis-generating and leaves open prospective validation.
BACKGROUND: Mobile cardiac masses on the coumadin ridge are rare and carry significant embolic risk, compounded by concurrent atrial fibrillation. Surgical excision may be prohibitive in patients with high bleeding risk. CASE SUMMARY: A 70-year-old man with paroxysmal atrial fibrillation, a HAS-BLED score of 4, and aversion to anticoagulation was referred for left atrial appendage (LAA) closure. Imaging revealed an incidental 0.56-cm mobile coumadin ridge mass consistent with papillary fibroelastoma. The Amplatzer Amulet was selected for its larger disc geometry to simultaneously occlude the LAA and exclude the mass, with follow-up confirming complete mass exclusion and stability at over 2 years. DISCUSSION: This is to our knowledge the first reported case of intentional simultaneous LAA occlusion and percutaneous mass exclusion, demonstrating a novel use of device geometry to manage dual embolic risk. TAKE-HOME MESSAGE: Concurrent LAA and coumadin ridge mass risk can be addressed in a single procedure through deliberate device selection using the Amulet's larger disc.
No takes yet. Share an insight, caveat, or question.
Ottersbach et al. (2026) conducted a case report in Paroxysmal atrial fibrillation and mobile coumadin ridge mass (papillary fibroelastoma) (n=1). Left atrial appendage occlusion and percutaneous mass exclusion using Amplatzer Amulet was evaluated on Complete coumadin ridge mass exclusion, LAA occlusion, and stability. Simultaneous LAA occlusion and percutaneous exclusion of a 0.56-cm coumadin ridge mass using an Amplatzer Amulet achieved complete mass exclusion and stability at >2 years in a 70-year-old man.
Synapse has enriched 10 related papers. Consider them for comparative context: