Related Experiment Video
Updated: Nov 13, 2025
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
84.1K
Successful WATCHMAN Device Placement Despite Left Atrial Appendage Perforation in Two Cases
Sangeeta Prabhakar Bhat1, Neil R Patel2, Nishant Sethi3
1Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, USA.
Cureus
|March 15, 2021
Summary
Left atrial appendage (LAA) perforation during WATCHMAN device placement for stroke prevention in non-valvular atrial fibrillation (NVAF) can be managed. Successful device deployment achieved hemostasis in one case, while another required pericardial window intervention.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Non-valvular atrial fibrillation (NVAF) patients with high stroke risk and bleeding complications are candidates for left atrial appendage (LAA) occlusion.
- The WATCHMAN device is used for LAA occlusion in NVAF patients unsuitable for oral anticoagulation.
- Left atrial appendage (LAA) perforation is a known complication during WATCHMAN device implantation.
Observation:
- Two NVAF cases with recurrent bleeding episodes underwent WATCHMAN procedures.
- Pericardial staining was observed during LAA device placement in both cases.
- A 27 mm WATCHMAN device was deployed in the LAA in both patients.
Findings:
- One patient achieved satisfactory hemostasis with device deployment, avoiding surgery.
- The second patient developed pericardial tamponade, necessitating a pericardial window procedure.
- This series is the first to describe WATCHMAN device use following LAA perforation detection.
Implications:
- WATCHMAN device deployment may be a viable strategy for LAA perforation during implantation.
- Management of LAA perforation requires careful consideration of patient factors and procedural outcomes.
- Further research is needed to establish optimal protocols for managing LAA perforation during device implantation.
