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      Large Cystic Intracardiac Mass Overlying Left Atrial Appendage Occlusion Device: A Case Report and Literature Review

      case-report
      Author(s): , MD, , MD, , MD, , MD, , MD
      Publication date (Electronic):
      Journal: CASE : Cardiovascular Imaging Case Reports
      Publisher: Elsevier
      Keywords: Watchman, Infection, Bacteremia, Thrombus

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          Graphical abstract

          Highlights

          • •

            The Watchman device is a possibility for patients with an elevated risk of stroke or bleeding.

          • •

            Device-related infection is extremely uncommon.

          • •

            Patient screening and selection prior to Watchman implantation are of vital importance.

          • •

            Device-related infection is related to peri-implantation bacteremia or inadequate sterility.

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          Most cited references10

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          Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

          Larry M Baddour, Walter Wilson, Arnold S. Bayer … (2015)
          Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances.
          Article 0 comments Cited 606 times – based on 0 reviews     Review now
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            Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation.

            J Blackshear, J. A. Odell (1996)
            Left atrial appendage obliteration was historically ineffective for the prevention of postoperative stroke in patients with rheumatic atrial fibrillation who underwent operative mitral valvotomy. It is, however, a routine part of modern "curative" operations for nonrheumatic atrial fibrillation, such as the maze and corridor procedures. To assess the potential of left atrial appendage obliteration to prevent stroke in nonrheumatic atrial fibrillation patients, we reviewed previous reports that identified the etiology of atrial fibrillation and evaluated the presence and location of left atrial thrombus by transesophageal echocardiography, autopsy, or operation. Twenty-three separate studies were reviewed, and 446 of 3,504 (13%) rheumatic atrial fibrillation patients, and 222 of 1,288 (17%) nonrheumatic atrial fibrillation patients had a documented left atrial thrombus. Anticoagulation status was variable and not controlled for. Thrombi were localized to, or were present in the left atrial appendage and extended into the left atrial cavity in 254 of 446 (57%) of patients with rheumatic atrial fibrillation. In contrast, 201 of 222 (91%) of nonrheumatic atrial fibrillation-related left atrial thrombi were isolated to, or originated in the left atrial appendage (p < 0.0001). These data suggest that left atrial appendage obliteration is a strategy of potential value for stroke prophylaxis in nonrheumatic atrial fibrillation.
            Article 0 comments Cited 347 times – based on 0 reviews     Review now
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              Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial.

              David Holmes, Saibal Kar, Matthew Price … (2014)
              In the PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) trial that evaluated patients with nonvalvular atrial fibrillation (NVAF), left atrial appendage (LAA) occlusion was noninferior to warfarin for stroke prevention, but a periprocedural safety hazard was identified.
              Article 0 comments Cited 279 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): CASE (Phila)
                Journal ID (iso-abbrev): CASE (Phila)
                Title: CASE : Cardiovascular Imaging Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 2468-6441
                Publication date PMC-release: 11 December 2020
                Publication date Collection: February 2021
                Publication date (Electronic): 11 December 2020
                Volume: 5
                Issue: 1
                Pages: 12-15
                Affiliations
                [1]Department of Cardiology and Division of Electrophysiology, Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
                Article
                Publisher Item ID: S2468-6441(20)30196-1
                DOI: 10.1016/j.case.2020.11.006
                PMC ID: 7887612
                SO-VID: 3c2cbd56-aeb1-447a-b5a8-861149210ea2
                Copyright © 2020 by the American Society of Echocardiography. Published by Elsevier Inc.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Categories
                Subject: Left Atrial Appendage

                Keywords: watchman,infection,bacteremia,thrombus
                Data availability:
                Keywords: watchman, infection, bacteremia, thrombus

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