Differentiating LAA Thrombus From Spontaneous Echo Contrast for Safe LAA Occlusion

JACC Case Reports 2026 Open access

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Authors: Ashraf Sliem, Steven Douedi, C. L. Chen, Daniel S. Ice
DOI: 10.1016/j.jaccas.2026.107760
Cited by: 1
References: 8

Abstract

Left atrial appendage (LAA) occlusion is a valuable therapeutic option for stroke prevention in patients with atrial fibrillation who have contraindication to long-term anticoagulation. However, the presence of LAA thrombus is a contraindication to device implantation. Differentiating a true thrombus from spontaneous echo contrast or "sludge" on transesophageal echocardiography is both challenging and crucial for procedural safety. We present a series of cases using adjunctive modalities that allowed safe LAA occluder deployment.

Fields of Study & Subjects

Atrial Fibrillation Management and Outcomes Cardiovascular and Diving-Related Complications Cardiac Arrhythmias and Treatments

Publication details

Journal / source
JACC Case Reports
Publisher
Elsevier BV
Volume
31
Issue
19
Pages
107760–107760
Publication date
3 April 2026
Language
EN