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European Journal of Echocardiography 2007 8(1):53-56; doi:10.1016/j.euje.2005.10.011
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Copyright © 2005, The European Society of Cardiology

Thrombus formation on an atrial septal defect closure device: A case report and review of the literature

Dimitar Divcheva,*, Arnd Schaefera, Martin Fuchsa, Thomas Breymannb, Helmut Drexlera and Gerd Peter Meyera

aDepartment of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
bDepartment of Cardiac and Thoracic Surgery, Hannover Medical School, Hannover, Germany

Received 19 July 2005; received in revised form 13 October 2005; accepted after revision 31 October 2005.

* Corresponding author. Tel.: +49 511 532 3818; fax: +49 511 532 3357. divchev.dimitar{at}mh-hannover.de


  Abstract

We report on a case of a mobile left atrial thrombus formation on an atrial septal defect occluder system (28mm StarFLEX®-Occluder) despite 6 months of postprocedural anticoagulation with phenprocoumon and platelet antiaggregation with aspirin in a 69-year-old woman. The closure was performed because of a significant left to right atrial shunt (Qp/Qs 1.8) with enlargement of the right atrial and ventricular cavities and impairment of right ventricular function in the presence of persistent atrial fibrillation and chronic heart failure (NYHA II–III). The 6-month follow up by transoesophageal echocardiography (TEE) revealed the floating thrombus located at the left atrial side of the occluder.

Keywords: TEE; transoesophageal echocardiography; ASD; atrial septal defect; PFO; patent foramen ovale; ASA; atrial septal aneurysm; INR; international normalized ratio


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