ArticleJACC. Case reports2026
Massive Device-Related Thrombus After Left Atrial Appendage Closure in Kidney Transplant Recipient With Hypertrophic Cardiomyopathy.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundAlthough left atrial appendage closure (LAAC) provides a crucial stroke prevention alternative for patients with atrial fibrillation (AF) who cannot undergo long-term anticoagulation, concurrent hypertrophic cardiomyopathy (HCM) elevates the risk of device-related thrombosis (DRT) after the procedure. CASE SUMMARY: This case report describes a 59-year-old woman with HCM, permanent AF, and a history of renal transplantation. Stroke prophylaxis was performed via LAAC with a 33-mm Watchman device. Premature discontinuation of dual-antiplatelet therapy 1 month postprocedure led to a large (5.2 cm × 2.5 cm) DRT identified at 6-month follow-up. The thrombus resolved completely after a prolonged, staged, and dose-adjusted course of rivaroxaban. DISCUSSION: The efficacy and safety of LAAC for stroke prevention in patients with HCM and AF who cannot tolerate anticoagulation remain debated TAKE-HOME MESSAGE: Although LAAC is not a standard stroke prevention therapy for HCM patients with AF, it represents a viable alternative in high-bleeding-risk scenarios and requires meticulous planning, vigilant DRT surveillance, and individualized antithrombotic management.
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