Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

06 July 2020 : Case report  Denmark

Direct Oral Anticoagulants After Percutaneous Patent Foramen Ovale (PFO) Closure: A Call for Caution

Unusual or unexpected effect of treatment, Adverse events of drug therapy

Ann Bovin1DEF, Henrik Vase2BD, Jens Erik Nielsen-Kudsk23ABD, Erik Lerkevang Grove23ADEF*

DOI: 10.12659/AJCR.922467

Am J Case Rep 2020; 21:e922467

Abstract

BACKGROUND: Transient atrial fibrillation (AF) following percutaneous patent foramen ovale (PFO) closure is common. Anticoagulation therapy should be considered in selected cases of prolonged AF after PFO closure, but guidelines do not provide clear recommendations on indication or choice of anticoagulant therapy for patients with post-procedural AF.

CASE REPORT: A 45-year-old woman presented with cryptogenic stroke verified by magnetic resonance imaging (MRI). Echocardiography revealed a PFO, which was closed percutaneously using a Gore septal occluder (25 mm). She was discharged on aspirin monotherapy (75 mg oral daily) according to institutional standard. Three weeks later, she presented with atrial fibrillation (AF). A direct oral anticoagulant (DOAC) (rivaroxaban 20 mg once daily) was initiated and aspirin was discontinued. After 4 months of follow-up, a routine echocardiography revealed large thrombi attached to both sides of the PFO occluder.

CONCLUSIONS: DOACs may be ineffective in preventing thrombus formation on device surfaces. Until more evidence has been provided, we suggest that DOACs are not routinely used for stroke prevention in patients following PFO closure or similar procedures within the first 3 months after device implantation.

Keywords: Anticoagulants, Atrial Fibrillation, foramen ovale, Thrombosis, Echocardiography, Factor Xa Inhibitors, Foramen Ovale, Patent, Rivaroxaban, Septal Occluder Device

Add Comment 0 Comments

In Press

Case report  USA

Concurrent Diagnosis of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma: Report of 2 Cases and Differe...

Am J Case Rep In Press; DOI: 10.12659/AJCR.944707  

Case report  Japan

“No-Touch” Saphenous Vein Grafting and Coronary Aneurysm Ligation in an Adult Patient with Suspected Prior ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.945431  

Case report  USA

Unexpected Chylous Ascites During Umbilical Hernia Repair in a Patient with Necrotizing Pancreatitis: A Cas...

Am J Case Rep In Press; DOI: 10.12659/AJCR.944609  

Case report  USA

A Rare Complication of Cannabinoid Hyperemesis Syndrome

Am J Case Rep In Press; DOI: 10.12659/AJCR.945106  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 57,146

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 42,303

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany 32,415

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

23 Feb 2022 : Case report  USA 19,841

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923