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Successful Percutaneous Retrieval of an Embolized Left Atrial Appendage Occluder.

ABSTRACT: A 75-year-old man with a previous mitral valve repair experienced embolization of a left atrial appendage occlusion device in the left atrium. The device was successfully retrieved using a double snaring technique, without the need for open surgery. This is an unusual report of left atrial appendage occluder retrieval, confirming the feasibility of the technique and the high flexibility of the device. (Level of Difficulty: Advanced.).

SUBMITTER: Ferraris F

PROVIDER: S-EPMC9847238 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Successful Percutaneous Retrieval of an Embolized Left Atrial Appendage Occluder.

Ferraris Federico F Millesimo Michele M Anselmino Matteo M Castagno Davide D Vairo Alessandro A Alunni Gianluca G De Ferrari Gaetano Maria GM

JACC. Case reports 20221130 24

A 75-year-old man with a previous mitral valve repair experienced embolization of a left atrial appendage occlusion device in the left atrium. The device was successfully retrieved using a double snaring technique, without the need for open surgery. This is an unusual report of left atrial appendage occluder retrieval, confirming the feasibility of the technique and the high flexibility of the device. (<b>Level of Difficulty: Advanced.</b>). ...[more]

PMID: 36684032

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Aortic Rupture and Hemorrhagic Shock After Percutaneous Retrieval of an Embolized Left Atrial Appendage Occluder.

Project description:Left atrial appendage (LAA) closure may be complicated by occluder embolization. Percutaneous retrieval is preferred for devices embolized to large vessels. In this report, the successful percutaneous retrieval of an LAA occluder embolized to the abdominal aorta was followed by several complications, culminating in iatrogenic aortic rupture requiring endovascular repair. (Level of Difficulty: Advanced.).

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Percutaneous retrieval of an embolized left atrial appendage closure device from the left atrium in a patient with previous MitraClips.

Project description:BackgroundLeft atrial appendage closure is increasingly used. LAA closure procedures can rarely be complicated by device embolization, typically towards the aorta. In this case report, we describe the successful percutaneous retrieval of an embolized Amulet device from the left atrium in a patient with previous MitraClips.Case presentationBy guidance of intracardiac echocardiography (ICE) and under local anaesthesia, two guiding systems were introduced into the LA; one to stabilize the device against the lateral LA wall and one large system to retrieve the device. However, the LAA closure device was finally snared by a three-loop snare and pulled across the interatrial septum (IAS) without taking the device into a protective guiding sheath - and this without tearing the IAS.ConclusionsIn conclusion, percutaneous retrieval of an embolized LAA closure device from the LA is feasible by transseptal approach under local anaesthesia and with ICE guidance.

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Successful Percutaneous Left Atrial Appendage Closure in the Presence of a Nonobstructive Appendage Membrane.

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Successful left atrial appendage closure using a percutaneous hepatic venous approach.

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Percutaneous Retrieval of a Left Atrial Appendage Closure Device: The Device Waltz.

Project description:Embolization of a device in patients undergoing percutaneous left atrial appendage closure is an uncommon complication. We present an illustrative case of successful percutaneous retrieval of an embolized LAmbre device (Lifetech Scientiﬁc, Shenzhen, China) that was achieved with a combination of a snaring technique and forceps grasping and by using a steerable guiding catheter. (Level of Difficulty: Advanced.).

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Transcatheter Extraction of a Migrated Left Atrial Appendage Occluder Device.

Project description:A 69-year-old man presented at 10 weeks postimplantation with a 31-mm Watchman FLX migrating into the left atrium. Due to incomplete left atrial appendage seal and embolization risk, transcatheter device extraction was performed without complications. Herein we describe the technique and procedural steps, using cardiac computed tomography and benchtop models to guide practice.

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Left atrial appendage perforation during appendage angiography treated by percutaneous left atrial appendage closure: a case report.

Project description:BackgroundPericardial effusion is a common complication of percutaneous left atrial appendage (LAA) closure. Acute management is the cornerstone of pericardial effusion treatment and interrupting the intervention is often required.Case summaryA 65-year-old man presented an acute 10 mm pericardial effusion following pigtail contrast appendage injection. A rapid Watchman Flex 24 mm (Boston Scientific) deployment permitted bleeding interruption. A needle pericardiocentesis was achieved in order to prevent any haemodynamical instability.DiscussionThis case report describes an atypical cause of pericardial effusion and a technique for bleeding control with LAA closure device deployment.

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Acute Mitral Regurgitation Secondary to Spontaneous Left Atrial Appendage Occluder Migration.

Project description:A patient underwent left atrial appendage occlusion due to recurrent stroke despite new oral anticoagulant therapy. The patient later presented with severe acute mitral regurgitation secondary to occluder device migration, which was retrieved percutaneously from the descending aorta via the femoral artery. Mitral surgical repair was required and successfully performed. (Level of Difficulty: Intermediate.).

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