Novel use of the Sentinel cerebral protection device during thrombosed septal occluder explant and Atriclip appendage closure.

Background: Our case demonstrates a novel use of the Sentinel™ cerebral protection device (SCPD) for prevention of stroke during removal of a thrombus-adherent atrial septal occluder.

Case Presentation: A 45-year-old male with multiple strokes and ostium secundum atrial septal defect closed ten years prior using an Amplatzer Septal Occluder presented with recurrent neurologic symptoms. Over the ensuing year, serial transesophageal echocardiography revealed persistent and worsening device-adherent thrombus despite trial of different anticoagulants.