Left atrial disc device thrombosis after atrial defect closure with the Gore® Cardioform septal occluder: A case series.
Peter KramerBernd Opgen-RheinFelix BergerJohannes NordmeyerPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2023)
Device thromboses after patent foramen ovale (PFO) and atrial septal defect (ASD) closure are rare but serious complications. They have been reported in different devices of virtually all manufacturers. Here, we report three cases of left atrial device thrombosis after atrial defect closure with the Gore® Cardioform septal occluder (GSO) in our recent institutional experience. All patients were symptomatic with new-onset neurological impairments and evidence of cerebral thromboembolism. Device thromboses have occurred despite antiplatelet therapy in two patients and moreover were observed late, at approximately 2 years after implantation, in two patients. One device was surgically explanted while in two cases, thrombi completely resolved with initiated anticoagulation. All patients had a favorable neurological recovery. Our observations suggest that regular follow-up echocardiography beyond 6 months after device implantation might be advisable in patients with GSO devices to rule out late device thromboses. More long-term follow-up data considering safety and late complications of contemporary PFO and ASD devices is required to establish confident evidence-based recommendations on long-term follow-up management and antithrombotic therapy regimen after PFO and ASD closure.
Keyphrases
- left atrial
- end stage renal disease
- atrial fibrillation
- chronic kidney disease
- newly diagnosed
- ejection fraction
- mitral valve
- peritoneal dialysis
- autism spectrum disorder
- computed tomography
- antiplatelet therapy
- machine learning
- pulmonary embolism
- mesenchymal stem cells
- acute coronary syndrome
- catheter ablation
- risk factors
- coronary artery disease
- attention deficit hyperactivity disorder
- subarachnoid hemorrhage
- bone marrow