Incomplete Left Atrial Appendage Closure Successfully Treated With a Redo Procedure

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.