Percutaneous left atrial appendage closure after resolution of left atrial appendage thrombi with dabigatran

• Published in: Orvosi hetilap Vol. 154; no. 7; p. 262
• Main Authors: Kis, Zsuzsanna, Földesi, Csaba, Pál, Mátyás, Som, Zoltán, Csillik, Andrea, Abrahám, Pál, Temesvári, András, Fontos, Géza, Szatmári, András, Andréka, Péter, Kardos, Attila
• Format: Journal Article
• Language: Hungarian
• Published: Hungary 17-02-2013
• Subjects: Anticoagulants - administration & dosage; Antithrombins - therapeutic use; Atherectomy; Atrial Appendage - diagnostic imaging; Atrial Appendage - pathology; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - therapy; Benzimidazoles - therapeutic use; beta-Alanine - analogs & derivatives; beta-Alanine - therapeutic use; Comorbidity; Dabigatran; Echocardiography, Transesophageal; Female; Heparin, Low-Molecular-Weight - administration & dosage; Humans; Middle Aged; Obesity, Morbid - complications; Risk Factors; Stroke - prevention & control; Thrombosis - diagnostic imaging; Thrombosis - drug therapy; Treatment Outcome
• ISSN: 0030-6002
• DOI: 10.1556/OH.2013.29550

The "gold standard" of the prevention of atrial fibrillation related thromboembolic events is anticoagulation therapy with oral vitamin K antagonists. A certain proportion of high-risk patients with atrial fibrillation are not receiving effective antithrombotic therapy because of problems associated with its use. Resolution of subsequent left atrial appendage thrombi is quite a great challenge in patients who are not tolerating "standard" antithrombotic drugs. According to the knowledge of the authors, this is the first report of a patient with non-valvular persistent atrial fibrillation and high stroke risk, who was intolerant to "standard" anticoagulant therapy and had persistent left atrial appendage thrombi following the use of a wide variety of "standard" anticoagulants. Successful resolution of left atrial appendage thrombi with dabigatran and successful percutaneous left atrial appendage closure were performed in this case.