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Updated: May 11, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous management of left atrial appendage perforation during device closure
Bernhard Meier1, Sergio G Tarbine, Costantino R Costantini
1Department of Cardiology, Bern University Hospital, Bern, Switzerland.
Insights
This study details a novel approach to managing left atrial appendage (LAA) perforation during LAA closure. A successful dual-device strategy resolved the complication, enabling safe LAA closure in a high-risk patient.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Percutaneous left atrial appendage (LAA) closure is an alternative to anticoagulation for stroke prevention in atrial fibrillation.
- Patients with atrial fibrillation and a history of gastrointestinal bleeding are often candidates for LAA closure.
- Complications during LAA closure, such as device malposition or perforation, require prompt management.
Abstract:
A 76-year-old male patient was admitted for percutaneous left atrial appendage (LAA) closure because of chronic atrial fibrillation and a history of gastrointestinal bleeding under oral anticoagulation. The procedure was complicated by perforation of the LAA with the lobe of the closure device being placed in the pericardial space. Keeping access to the pericardial space with the delivery sheath, the LAA closure device was replaced by an atrial septal defect closure device to seal the perforation. Then the initial LAA closure device was reimplanted in a correct position. Needle pericardiocentesis was required but the subsequent course was uneventful.
