Catheterization and Cardiovascular Interventions

Volume 92, Issue 1 pp. 200-202

Valvular and Structural Heart Diseases

Thromboembolism after WATCHMAN^TM in a clopidogrel non-responder: A case for concern?

Ganesh Venkataraman MD,

Ganesh Venkataraman MD

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Kevin P. Bliden MBA,

Kevin P. Bliden MBA

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Udaya S. Tantry PhD,

Udaya S. Tantry PhD

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Paul A. Gurbel MD,

Corresponding Author

Paul A. Gurbel MD

[email protected]

orcid.org/0000-0002-7289-0036

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

Correspondence Paul A. Gurbel, M.D., Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, 3300 Gallows Road, Falls Church, VA 22042. Email: [email protected]Search for more papers by this author

Ganesh Venkataraman MD,

Ganesh Venkataraman MD

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Kevin P. Bliden MBA,

Kevin P. Bliden MBA

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Udaya S. Tantry PhD,

Udaya S. Tantry PhD

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

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Paul A. Gurbel MD,

Corresponding Author

Paul A. Gurbel MD

[email protected]

orcid.org/0000-0002-7289-0036

Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia

First published: 11 November 2017

https://doi.org/10.1002/ccd.27402

Citations: 1

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Abstract

Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN^TM 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 WATCHMAN^TM 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.

CONFLICT OF INTEREST

Dr. Paul Gurbel discloses the following relationships: Grants from Haemonetics, DCRI, Medicure, Merck, NIH, Bayer, Amgen, Medimmune, and Coramed, and personal fees from AstraZenaeca, Boehringer, Merck, Janssen, Bayer, Medicure, and Haemonetics, UptoDate; in addition, Dr. Gurbel has a patent Platelet function testing issued.

Supporting Information

REFERENCES

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Volume92, Issue1

July 2018

Pages 200-202

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Thromboembolism after WATCHMAN^TM in a clopidogrel non-responder: A case for concern?

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

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Thromboembolism after WATCHMAN^TM in a clopidogrel non-responder: A case for concern?