Recurrent Stroke due to Patent Foramen Ovale Closure Device Thrombus Eight Years after Implantation

Kodankandath, Thomas V.; Mishra, Sanskriti; Libman, Richard B.; Wright, Paul

doi:10.1016/j.jstrokecerebrovasdis.2016.06.037

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…Current observations suggest that device related thrombosis resolves within 4 weeks to 6 months after starting treatment [28]. Surgical thrombectomy has been required in select cases due to thrombus size, friability or device failure [25,29,30]. Theorized mechanisms for thrombus formation are centered around an impaired coagulation cascade, poor epithelialization of the device and foreign body reaction [31,32,33].…”

Section: Discussionmentioning

confidence: 99%

Large Left Atrial Thrombus on Amplatzer Septal Occluder Secondary to Medication Nonadherence

Hossain¹,

Kariyanna²,

Hossain³

et al. 2020

AJMCR

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Patent foramen ovale (PFO) is a common clinical entity that is encountered in 20-34% of the general population. In most individuals, this anatomical variation is asymptomatic and goes undetected throughout their lives or is only incidentally discovered on cardiac investigations. In situations when the conduit is large enough and when the right atrial pressure exceeds the left atrial pressure, right to left interatrial flow may occur in these individuals. This creates a channel for translocation of air or thrombi from the venous to the arterial circulation, a phenomenon known as paradoxical embolism. Approximately 25-40% of strokes and transient ischemic attacks in patients less than 60 years of age are classified as cryptogenic and studies have identified a higher prevalence (60%) of PFO in young adults with strokes of unidentifiable etiology. Recent trials have demonstrated utility of PFO closure with mechanical devices for secondary prevention of recurrent strokes in patients aged <60 years of age. The general consensus of post-operative management of PFO closure has been largely drawn from randomized controlled trials and comprises use of aspirin and clopidogrel for 6 months followed by use of aspirin alone for at least 5 years. We present a case of an incidentally discovered left intra-atrial thrombus attached to a PFO closure device in a 36-yearold female with a history of cryptogenic stroke three months after implantation.

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Section: Discussionmentioning

confidence: 99%

Large Left Atrial Thrombus on Amplatzer Septal Occluder Secondary to Medication Nonadherence

Hossain¹,

Kariyanna²,

Hossain³

et al. 2020

AJMCR

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“…8 The most frequent neurological events occur within the first 12 months, and only a few cases of recurrent strokes are reported to have occurred 5 years or longer after device closure of intracardiac shunt. [9][10][11] Currently, most of the intracardiac shunts, regardless of ASD or PFO, are performed using percutaneous devices, as in the above-mentioned cases. The unique feature of the present case is that ASD closure was performed surgically and stroke recurrence occurred three times over a time period that was more prolonged than described in previous reports.…”

Section: Discussionmentioning

confidence: 99%

Stroke Recurrence in a Patient Twelve Years after Repair of a Secundum Atrial Septal Defect

Seo

et al. 2018

J Neurocrit Care

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Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.

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Vascular Closure Devices and Thrombosis

Ryan¹,

Clapp²

2018

Cardiovascular Thrombus

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Recurrent Stroke due to Patent Foramen Ovale Closure Device Thrombus Eight Years after Implantation

Cited by 8 publications

References 4 publications

Large Left Atrial Thrombus on Amplatzer Septal Occluder Secondary to Medication Nonadherence

Large Left Atrial Thrombus on Amplatzer Septal Occluder Secondary to Medication Nonadherence

Stroke Recurrence in a Patient Twelve Years after Repair of a Secundum Atrial Septal Defect

Vascular Closure Devices and Thrombosis

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