Thromboembolism after WATCHMANTM in a clopidogrel non‐responder: A case for concern?

Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMANTM left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non‐valvular AF. Here, we present a case of a patient with device‐related th...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2018-07, Vol.92 (1), p.200-202
Main Authors: Venkataraman, Ganesh, Bliden, Kevin P., Tantry, Udaya S., Gurbel, Paul A.
Format: Article
Language:English
Subjects:
Aspirin
atrial fibrillation
Clopidogrel
Fibrillation
Health risks
Stroke
Thromboembolism
Thrombosis
Warfarin
WATCHMAN
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Description
Summary:Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMANTM left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non‐valvular AF. Here, we present a case of a patient with device‐related thrombus who suffered a TE event two months after WATCHMANTM LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non‐responder to clopidogrel therapy. We discuss the potential role of platelet function testing to prevent device‐related thrombi.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.27402