Left atrial thrombus after complete left atrial appendage exclusion with LARIAT device.

A 74-year-old woman with paroxysmal atrial fibrillation underwent left atrial appendage (LAA) exclusion with a LARIAT snare device. Transesophageal echocardiogram one month later demonstrated a left atrial thrombus at orifice of the completely occluded LAA that subsequently resolved with two months of anticoagulation. This case highlights that LAA ligation with LARIAT device continues to pose a risk for left atrial thrombosis in the immediate post-operative period. It also emphasizes the need for further evidence regarding antiplatelet and anticoagulation therapy in these patients. © 2014 Wiley Periodicals, Inc.