Successful Left Atrial Appendage Closure with Watchman Device Implantation in Two Patients with Inferior Vena Cava Filters
Keywords:Atrial fibrillation, Oral anticoagulation contraindication, Left atrial appendage closure, Percutaneous intervention, Vena cava filters
Percutaneous procedures through femoral access in patients with inferior vena cava (IVC) filter may be at risk of complications. We evaluated the feasibility and safety of left atrial appendage closure (LAAC) through femoral access in patients previously implanted with IVC filter. We described the WatchmanTM device implantation in two patients with formal contraindication for oral anticoagulation. First patient had a GreenfieldTM filter and the second one an OpteaseTM filter, and in this patient an attempt to withdrawal the filter immediately before the LAAC procedure failed. A femoral approach was performed in both patients using a 14 Fr sheath. Before crossing IVC filters, venographies did not detect any thrombus. All steps of IVC filter crossing were performed under fluoroscopic guidance. No immediate or intrahospital complications related to the procedure occurred. Herein, we presented two cases of successful LAAC closure with Watchman device in patients with two different kinds of IVC filters.
Magalhães LP, Figueiredo MJO, Cintra FD, Saad EB, Kuniyoshi RR, Teixeira RA, et al. II Diretrizes Brasileiras de Fibrilação Atrial. Arq Bras Cardiol. 2016;106(4 Suppl. 2):1-22.
2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):546-7. https://doi.org/10.1093/eurheartj/ehaa945
Kaufman JA, Thomas JW, Geller SC, Rivitz SM, Waltman AC. Guide-wire entrapment by inferior vena caval filters: in vitro evaluation. Radiology. 1996;198(1):71-6. https://doi.org/10.1148/radiology.198.1.8539409
Andrews RT, Geschwind JF, Savader SJ, Venbrux AC. Entrapment of J-tip guidewires by Venatech and stainless-steel Greenfield vena cava filters during central venous catheter placement: percutaneous management in four patients. Cardiovasc Intervent Radiol.1998;21(5):424-8. https://doi.org/10.1007/s002709900292
Stavropoulos SW, Itkin M, Trerotola SO. In vitro study of guide wire entrapment in currently available inferior vena cava filters. J Vasc Interv Radiol. 2003;14(7):905-10. https://doi.org/10.1097/01.rvi.0000082827.75926.10
Haman L, Parizek P, Maly R, Vojacek J. Cavotricuspid isthmus catheter ablation across an inferior vena cava filter. Pacing Clin Electrophysiol. 2006;29(3):331-3. https://doi.org/10.1111/j.1540-8159.2006.00343.x
Jez J, Starek Z, Lehar F, Wolf J, Novak M. Complex electrophysiology intervention in a patient with an inferior vena cava filter. Cor Vasa. 2015;57(5):e341-6. https://doi.org/10.1016/j.crvasa.2015.05.005
Schoeffler M, Ringewald J, Schechter E. Transfemoral venous access through inferior vena cava filters for interventions requiring large sheaths. Catheter Cardiovasc Interv. 2007;69(1):47-51. https://doi.org/10.1002/ccd.20933
Sinha SK, Harnick D, Gomes JA, Mehta D. Electrophysiologic interventions in patients with inferior vena cava filters: safety and efficacy of the transfemoral approach. Heart Rhythm. 2005;2(1):15-8. https://doi.org/10.1016/j.hrthm.2004.09.026
Shariff N, Aleem A, Singh M, Li Y, Smith S. AF and venous thromboembolism– pathophysiology, risk assessment and CHADS-VASc score. J Atr Fibrillation. 2012;5(3):649. https://doi.org/10.4022/jafib.649
Enga KF, Rye-Holmboe I, Hald EM, Lochen M-L, Mathiesen EB, Njolstad I, et al. Atrial fibrillation and future risk of venous thromboembolism:the Troms. study. J Thromb Haemost. 2015;13(1):10-6. https://doi.org/10.1111/jth.12762
El Ayech F, Ternacle J, Boudiche S, Gallet R, Boukantar M, Hamon D, et al. Percutaneous left atrial appendage closure in patients with inferior vena cava filters: a case series. J Invasive Cardiol. 2019;31(5):128-32.
Okutucu S, Ates I, Marmagkiolis K, Kose G, Iliescu C, Cilingiroglu M. Successful Watchman device implantation in a patient with IVC filter thrombosis and iliac vein occlusions. Cardiovasc Revasc Med. 2020;21(3):409-11. https://doi.org/10.1016/j.carrev.2019.05.028
Sader MA, De Moor M, Pomerantsev E, Palacios IF. Percutaneous transcatheter patent foramen ovale closure using the right internal jugular venous approach. Catheter Cardiovasc Interv. 2003;60(4):536-9. https://doi.org/10.1002/ccd.10702
Lim HE, Pak H-N, Tse H-F, Lau C-P, Hwang C, Kim Y-H. Catheter ablation of atrial fibrillation via superior approach in patients with interruption of the inferior vena cava. Heart Rhythm. 2009;6(2):174-9. https://doi.org/10.1016/j.hrthm.2008.10.026
Hussain J, Strumpf R, Ghandforoush A, Jamal A, Diethrich E. Transhepatic approach to closure of patent foramen ovale: report of 2 cases in adults. Tex Heart Inst J. 2010;37(5):553-6. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2953222/
Johnson JL, Fellows KE, Murphy JD. Transhepatic central venous access for cardiac catheterization and radiologic intervention. Cathet Cardiovasc Diagn. 1995;35(2):168-71. https://doi.org/10.1002/ccd.1810350219
How to Cite
Copyright (c) 2021 Fabricio Vassallo
This work is licensed under a Creative Commons Attribution 4.0 International License.