LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO
Background: Left atrial appendage (LAA) occlusion (LAAO) is used to prevent thromboembolic events in high stroke risk patients. However, surgical LAA closure can fail, resulting in residual flow and thrombus formation. Case Summary: A 77-year-old man with a history of bioprosthetic valve replacement...
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| Language: | English |
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Elsevier
2025-07-01
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| Series: | JACC: Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666084925005698 |
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| author | Vladyslav Kavalerchyk, MD Stephan Stöbe, MD Andreas Hagendorff, MD Torsten Doenst, MD Ritu Thamman, MD |
| author_facet | Vladyslav Kavalerchyk, MD Stephan Stöbe, MD Andreas Hagendorff, MD Torsten Doenst, MD Ritu Thamman, MD |
| author_sort | Vladyslav Kavalerchyk, MD |
| collection | DOAJ |
| description | Background: Left atrial appendage (LAA) occlusion (LAAO) is used to prevent thromboembolic events in high stroke risk patients. However, surgical LAA closure can fail, resulting in residual flow and thrombus formation. Case Summary: A 77-year-old man with a history of bioprosthetic valve replacements and prophylactic LAA closure presented with dizziness. Brain magnetic resonance imaging showed microembolic infarcts, and transesophageal echocardiography revealed suture insufficiency with LAA thrombus. Given the patient’s preference to avoid long-term anticoagulation, an Amplatzer device was used for LAAO. Postprocedural transesophageal echocardiography confirmed successful occlusion, and the patient remained stroke free on aspirin alone on follow-up. Discussion: This case highlights the limitations of surgical LAA closure and the role of LAAO as an alternative treatment to mitigate thromboembolic risk in high-risk patients. It underscores the importance of accurate imaging in therapy planning. Take-Home Message: LAAO offers a viable option for patients with failed surgical LAA closure, balancing stroke prevention with bleeding risk. |
| format | Article |
| id | doaj-art-be5cb7809b4a4cd48cba55a3af01bf5f |
| institution | Matheson Library |
| issn | 2666-0849 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Case Reports |
| spelling | doaj-art-be5cb7809b4a4cd48cba55a3af01bf5f2025-07-04T04:46:53ZengElsevierJACC: Case Reports2666-08492025-07-013017103791LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAOVladyslav Kavalerchyk, MD0Stephan Stöbe, MD1Andreas Hagendorff, MD2Torsten Doenst, MD3Ritu Thamman, MD4Department of Cardiology and Angiology, Helios-Kliniken Schwerin, Schwerin, GermanyDepartment of Cardiology, University of Leipzig, Leipzig, GermanyDepartment of Cardiology, University of Leipzig, Leipzig, GermanyDepartment of Cardiothoracic Surgery, Jena University Hospital, Jena, GermanyUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Address for correspondence: Dr Ritu Thamman, University of Pittsburgh School of Medicine, 490 East North Avenue, Suite G104, Pittsburgh, Pennsylvania 15212, USA.Background: Left atrial appendage (LAA) occlusion (LAAO) is used to prevent thromboembolic events in high stroke risk patients. However, surgical LAA closure can fail, resulting in residual flow and thrombus formation. Case Summary: A 77-year-old man with a history of bioprosthetic valve replacements and prophylactic LAA closure presented with dizziness. Brain magnetic resonance imaging showed microembolic infarcts, and transesophageal echocardiography revealed suture insufficiency with LAA thrombus. Given the patient’s preference to avoid long-term anticoagulation, an Amplatzer device was used for LAAO. Postprocedural transesophageal echocardiography confirmed successful occlusion, and the patient remained stroke free on aspirin alone on follow-up. Discussion: This case highlights the limitations of surgical LAA closure and the role of LAAO as an alternative treatment to mitigate thromboembolic risk in high-risk patients. It underscores the importance of accurate imaging in therapy planning. Take-Home Message: LAAO offers a viable option for patients with failed surgical LAA closure, balancing stroke prevention with bleeding risk.http://www.sciencedirect.com/science/article/pii/S2666084925005698oral anticoagulants (OACs)atrial fibrillation (AF)left atrial appendage (LAA)left atrial appendage occlusion (LAAO) |
| spellingShingle | Vladyslav Kavalerchyk, MD Stephan Stöbe, MD Andreas Hagendorff, MD Torsten Doenst, MD Ritu Thamman, MD LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO JACC: Case Reports oral anticoagulants (OACs) atrial fibrillation (AF) left atrial appendage (LAA) left atrial appendage occlusion (LAAO) |
| title | LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO |
| title_full | LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO |
| title_fullStr | LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO |
| title_full_unstemmed | LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO |
| title_short | LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO |
| title_sort | laa thrombus and stroke from surgical laa closure failure from suture insufficiency treated with laao |
| topic | oral anticoagulants (OACs) atrial fibrillation (AF) left atrial appendage (LAA) left atrial appendage occlusion (LAAO) |
| url | http://www.sciencedirect.com/science/article/pii/S2666084925005698 |
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