Background: Vitamin K antagonists (VKAs) have been regarded as the therapy of choice for intracardiac thrombosis for decades based mostly on observational data. The advent of direct oral anticoagulants (DOACs) has displaced VKAs as the first-line therapy for multiple thrombotic disorders but not for intracardiac thrombosis. Although limited, there is growing evidence that DOACs are effective for intracardiac thrombosis and some data suggest that thrombus resolution might be superior to that with warfarin.
Case Summary: Here, we present a series of six patients with left atrial appendage thrombi were treated with a venous thromboembolic dose of DOACs with resolution within 2-6 months with no reported complications.
Discussion: This case series adds to the accumulating evidence supporting the efficacy of DOACs in the treatment of intracardiac thrombi.
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| http://dx.doi.org/10.1093/ehjcr/ytaa181 | DOI Listing |
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Article Synopsis
- * Left atrial appendage closure (LAAC) is a viable option for these patients, and transesophageal echocardiography (TEE) is the traditional imaging method to assist in this procedure, although it typically requires general anesthesia, which poses additional risks for older adults.
- * Intracardiac echocardiography (ICE) offers a "minimalist approach" that avoids anesthesia but has issues with image quality; recently, using ICE in conjunction with TEE (ICE-TEE) has
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