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Updated: Dec 16, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Late presentation of left atrial appendage erosion and perforation by an Amplatzer™ Amulet™ closure device: a case
Ben Wilkins1, Christian L Carranza2, Lars Søndergaard1
1Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Insights
Late erosion of the Amplatzer Amulet device after percutaneous left atrial appendage (LAA) closure caused pericardial tamponade. This rare complication highlights the importance of recognizing potential LAA device erosion risks.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Percutaneous left atrial appendage (LAA) closure is a prophylactic procedure to reduce cardioembolic stroke risk in non-valvular atrial fibrillation.
- Identifying and managing potential complications is crucial for patient safety.
Observation:
- A 73-year-old male presented with syncope and acute pericardial tamponade 14 months post-LAA closure.
- Surgical exploration revealed tissue erosion by the Amplatzer Amulet LAA closure device at the disc and lobe.
Findings:
- This case represents a temporally remote complication of LAA closure.
- Device erosion at two distinct anatomical locations (disc and lobe) is a previously undescribed finding.
Implications:
- This case underscores the importance of understanding the anatomical relationships between the LAA and surrounding structures.
- Recognizing the risk of late device erosion is critical for managing patients after LAA closure procedures.
Background:
Percutaneous left atrial appendage (LAA) closure may reduce the risk of cardioembolic stroke in patients with non-valvular atrial fibrillation. Given the prophylactic nature of the procedure, identifying and managing complications are paramount.
Case Summary:
A 73-year-old man presented 14 months after percutaneous LAA closure with syncope and acute pericardial tamponade which required surgical exploration and haemostasis; the most temporally remote account of this complication albeit amongst very few case reports. Tissue erosion by the Amplatzer™ Amulet™ LAA closure device (Abbott, Plymouth, MN, USA) was noted at two separate anatomical locations, corresponding to the device disc and lobe, which has not been described previously.
Discussion:
This case report highlights the anatomical relationship between the LAA and its surrounding structures, and the importance of recognizing the risk of late device erosion.
