Percutaneous closure of a left atrial appendage with relevant suture dehiscence

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Atrial fibrillation is a common condition associated with a significant risk of ischemic stroke.
• Surgical left atrial appendage closure is a standard procedure during open-heart surgery for thromboembolic risk reduction in atrial fibrillation patients.
• Suture dehiscence of a surgically closed left atrial appendage can occur years after the initial procedure.

Purpose of the Study:

• To report a successful percutaneous closure of a left atrial appendage.
• To highlight the management of a rare complication of surgical left atrial appendage closure: suture dehiscence.
• To demonstrate an alternative treatment option for patients with failed surgical left atrial appendage closure.

Main Methods:

• Percutaneous closure of the left atrial appendage.
• Diagnostic imaging to confirm suture dehiscence.
• Follow-up assessment of the percutaneous closure device.

Main Results:

• Successful percutaneous closure of the left atrial appendage was achieved.
• The patient had experienced clinically relevant suture dehiscence several years after surgical closure.
• The percutaneous closure provided effective thromboembolic protection.

Conclusions:

• Percutaneous closure is a viable option for managing late suture dehiscence after surgical left atrial appendage closure.
• This approach can effectively mitigate the risk of stroke in patients with atrial fibrillation and failed surgical LAA closure.
• Further research into long-term outcomes of percutaneous closure for failed surgical LAA closure is warranted.