Multi-modality approach to detect device-related thrombus after left atrial appendage occlusionMaiga, Hamady Ibrahim (Avtor) Ambrožič, Jana (Avtor) Jug, Borut (Avtor) Cvijić, Marta (Avtor) atrial fibrillationcardiac computer tomographyleft atrial appendage occlusiontransoesophageal echocardiographyBackground: There has been a growing interest in using left atrial appendage occlusion (LAAO) for stroke prevention in patients with atrial fibrillation (AF) who are ineligible for oral anticoagulation. However, device-related thrombus (DRT) may occur after LAAO implantation and poses significant diagnostic and treatment challenges. Case summary: We describe a case of a patient who suffered an intracranial pontine haemorrhage while on anticoagulation with rivaroxaban for permanent atrial fibrillation and successfully underwent implantation of the LAAO device. Early follow-up transoesophageal echocardiography (TOE) with 3D multi-plane reconstruction revealed a large echo-dense mass on the left atrial aspect of the device. Cardiac computed tomography angiography confirmed a thrombus adherent to the LAAO device. After deciding on the treatment strategy, complete thrombus resolution was achieved at the 6 months follow-up and the patient was free of any thromboembolic and bleeding events. Discussion: Although DRT is a rare complication following LAAO procedure, an accurate diagnosis is crucial for the specific treatment. Multi-modality imaging approach with TOE and cardiac computed tomographic angiography as complementary methods is helpful to detect complications after LAAO procedure in challenging cases.20252026-01-07 07:50:53Neznano24979UDK: 616.1ISSN pri članku: 2514-2119DOI: 10.1093/ehjcr/ytaf363COBISS_ID: 263660547sl