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        Heart within a Heart

        Tarun Jain,Jainil Shah,Sunay Shah,Shalini Modi 한국심초음파학회 2016 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.24 No.1

        Device based closure of the left atrial appendage (LAA) has emerged as a viable approach for stroke prevention in atrial fibrillation(AF) patients with contraindications to chronic oral anticoagulation. One of the most feared complications is device relatedthrombus formation. We present a 66-year-old male with chronic AF who developed a life-threatening intracranial bleed on oralanti-coagulation. He subsequently underwent LAA closure using an Amplatzer muscular ventricular septal defect closure devicefor stroke prevention. However, he was found to have a large thrombus attached to the device a year later. We present a review ofthe various LAA closure devices, importance of periodic surveillance via echocardiography and management options to preventthis complication. Also, the case highlights the importance of contrast-enhance echocardiography in diagnosis of LAA closure devicethrombus.

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