Left Atrial Appendage Occlusion Complicated by Appendage Perforation Rescued by Device Deployment

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Device Technology

Background:

• The Watchman device is utilized for left atrial appendage occlusion in nonvalvular atrial fibrillation patients unsuitable for long-term anticoagulation.
• Complications such as pericardial effusion and perforation during Watchman device deployment can be severe, potentially necessitating surgical intervention.

Purpose of the Study:

• To present a rare case of left atrial appendage perforation during Watchman device implantation.
• To highlight the successful non-surgical management of this complication through device repositioning.

Main Methods:

• A case report detailing the implantation of a Watchman device in a patient with nonvalvular atrial fibrillation.
• Description of the intra-procedural identification of left atrial appendage perforation.
• Explanation of the technique used for successful device repositioning to seal the perforation.

Main Results:

• Left atrial appendage perforation occurred during Watchman device implantation.
• The perforation was successfully managed by repositioning the Watchman device.
• Surgical intervention was avoided, and the patient experienced a favorable outcome.

Conclusions:

• Left atrial appendage perforation is a rare but serious complication of Watchman device implantation.
• Successful device repositioning can be an effective alternative to surgery in managing this complication.
• Experienced operators can minimize risks, but preparedness for managing complications is crucial.