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Published on: February 26, 2013
Incomplete Left Atrial Appendage Closure Successfully Treated With a Redo Procedure
Francesco Tomassini1, Paolo Giay Pron1, Stefania Ferrua1
1Department of Cardiology, Infermi Hospital, Rivoli, Italy.
Insights
A patient with atrial fibrillation had a left atrial appendage closure device implanted. A subsequent echocardiogram revealed incomplete closure, necessitating a second device implantation for successful occlusion.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of thromboembolism.
- Left atrial appendage (LAA) closure is an alternative to anticoagulation in patients with high bleeding risk.
- Device implantation for LAA closure requires precise positioning to ensure efficacy.
Observation:
- A 68-year-old male with permanent atrial fibrillation and high bleeding risk underwent LAA closure.
- Transesophageal echocardiography (TEE) one month post-procedure revealed incomplete LAA occlusion due to device malposition.
- The incomplete occlusion posed a continued risk of thrombus formation.
Findings:
- A second, different LAA closure device was successfully implanted.
- The new device achieved complete occlusion of the left atrial appendage.
- This resolved the risk associated with incomplete closure.
Implications:
- Successful LAA closure is crucial for stroke prevention in AF patients.
- Device malposition can compromise the efficacy of LAA closure.
- Careful patient selection and procedural technique are vital for optimal outcomes in LAA closure procedures.
Abstract:
A 68 year's old man with permanent atrial fibrillation, underwent a left atrial appendage closure because of high bleeding risk. However, after one month, an incomplete occlusion of the left atrial appendage due to a too deep position of the device, was detected by a transesophageal echocardiogram. Considering the residual high risk of thrombi formation, a new different device was successfully implanted with a correct closure of the appendage.
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