{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:28Z","timestamp":1753876228765,"version":"3.41.2"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Left atrial appendage (LAA) thrombus is a contraindication for LAA closure (LAAC). However, in selected cases, oral anticoagulants are strictly contraindicated because of a history of life-threatening bleeding, and LAAC remains the only possible therapy to avoid systemic and especially cerebral embolization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report a case of LAAC despite a massive proximal thrombus in a patient who had an absolute contraindication to anticoagulant therapy, with thorough pre-planning using CT scan, device modelling and thrombus trapping techniques to reduce the risk of systemic embolic events and perform LAAC safely.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Although LAAC remains at high risk in this setting, the use of cautious techniques and tools, from pre-procedure planning to systemic embolization prevention systems associated to a precise transoesopheageal echocardiography guiding throughout the procedure, allows it to be performed as safely as possible when no other option is available.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae286","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T14:05:54Z","timestamp":1718028354000},"source":"Crossref","is-referenced-by-count":0,"title":["Case report: three ways to mitigate the risk of embolization during left atrial appendage closure in a patient with a massive and proximal left atrial appendage thrombus"],"prefix":"10.1093","volume":"8","author":[{"given":"Sandra","family":"Zendjebil","sequence":"first","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS), H\u00f4pital Jacques Cartier, Ramsay-Sant\u00e9 , 6 avenue du Noyer Lambert, Massy 91300 , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9r\u00f4me","family":"Horvilleur","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS), H\u00f4pital Jacques Cartier, Ramsay-Sant\u00e9 , 6 avenue du Noyer Lambert, Massy 91300 , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Boil\u00e8ve","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS), H\u00f4pital Jacques Cartier, Ramsay-Sant\u00e9 , 6 avenue du Noyer Lambert, Massy 91300 , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Millien","sequence":"additional","affiliation":[{"name":"Service de cardiologie, Centre hospitalier Saint Quentin , Saint Quentin , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8960-7006","authenticated-orcid":false,"given":"Philippe","family":"Garot","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS), H\u00f4pital Jacques Cartier, Ramsay-Sant\u00e9 , 6 avenue du Noyer Lambert, Massy 91300 , France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"2024062714253971800_ytae286-B1","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.4244\/EIJ-D-17-00777","article-title":"Percutaneous left atrial appendage occlusion in patients with atrial fibrillation and left appendage thrombus: feasibility, safety and clinical efficacy","volume":"13","author":"Tarantini","year":"2018","journal-title":"EuroIntervention"},{"key":"2024062714253971800_ytae286-B2","doi-asserted-by":"crossref","first-page":"50-","DOI":"10.4244\/EIJ-D-21-00713","article-title":"Left atrial appendage closure for thrombus trapping: the international, multicentre TRAPEUR registry","volume":"18","author":"Sebag","year":"2022","journal-title":"EuroIntervention"},{"key":"2024062714253971800_ytae286-B3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jacep.2019.11.017","article-title":"Feasibility of left atrial appendage occlusion in left atrial appendage thrombus","volume":"6","author":"Sharma","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2024062714253971800_ytae286-B4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/ccd.26677","article-title":"Rationale of cerebral protection devices in left atrial appendage occlusion","volume":"89","author":"Meincke","year":"2017","journal-title":"Catheter Cardiovasc Interv."},{"key":"2024062714253971800_ytae286-B5","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/ccd.27117","article-title":"Watchman in ascending aorta for systemic protection (WAASP): novel use of Watchman in ascending aorta for embolic protection-first in man","volume":"92","author":"Yadav","year":"2018","journal-title":"Catheter Cardiovasc Interv"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae286\/58193915\/ytae286.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/6\/ytae286\/58346576\/ytae286.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/6\/ytae286\/58346576\/ytae286.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T14:37:00Z","timestamp":1719499020000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae286\/7690826"}},"subtitle":[],"editor":[{"given":"Can","family":"Collmann-Tepek\u00f6yl\u00fc","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Dino","family":"Miric","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Anas Mohamad","family":"Hashem","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Emmanouil","family":"Mantzouranis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":5,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae286","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,6,1]]},"article-number":"ytae286"}}