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Updated: Oct 5, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Successful percutaneous left atrial appendage occlusion for atrial fibrillation in a patient with mirror-image
Jizhe Xu1, Gaxue Jiang1, Lu Zhang1
1Heart Center, Gansu Heart Center, Key Laboratory for Cardiovascular Disease of Gansu, The First Hospital of Lanzhou University, Lanzhou, China.
Background:
Dextrocardia is a rare congenital condition (1/10,000-12,000) and AF is uncommon (1-2%). Therefore, the occurrence of the two conditions is rare. Percutaneous left atrial appendage occlusion (LAAO) is a treatment to prevent atrial fibrillation (AF)-associated thromboembolic events.
Case Presentation:
An 85-year-old female with known situs inversus totalis, persistent AF, and stroke was treated with oral anticoagulation, but she was suffering from constant gingival bleeding. Her CHA2DS2VASc score was 6 points (abnormal, ≥ 2), and her HAS-BLED score was 4 points (abnormal, ≥ 3). The transthoracic echocardiography (TTE) demonstrated left atrial (LA) enlargement (46 mm) and 50% of ejection fraction. She underwent percutaneous LAAO for stroke recurrence prevention using a Watchman occluder. The operation was successful but with technical differences compared with a standard case because of the dextrocardia.
Conclusion:
This is the first reported case of a percutaneous LAAO in situs inversus dextrocardia. This case indicates the feasibility of LAAO in congenital cardiac malposition combined with AF.
