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Updated: Oct 1, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Watchman Device Dislodgement Creating a Left Ventricular Outflow Tract Obstruction Requiring Emergency
Alex Roberts1, Steven Mach1, Jason Goebel1
1Grand Strand Regional Medical Center, Myrtle Beach, SC, USA.
Insights
Left atrial appendage occlusion is a common stroke prevention method for atrial fibrillation patients. A rare complication of device dislodgement caused aortic valve stenosis, requiring emergency retrieval.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Left atrial appendage (LAA) occlusion is an alternative stroke prophylaxis for nonvalvular atrial fibrillation (AF) patients intolerant to anticoagulation.
- Successful LAA device deployment rates are reported at 98.5%.
Observation:
- A case of a Watchman LAA occlusion device dislodgement and migration is presented.
- The migrated device caused functional aortic valve stenosis, leading to left ventricular outflow tract (LVOT) obstruction.
Findings:
- Device migration is a rare but known complication of LAA occlusion.
- Successful emergency retrieval of the dislodged device was performed using cardiopulmonary bypass.
Implications:
- This case highlights the importance of vigilance for rare LAA device complications.
- Prompt intervention is crucial for managing device migration and associated hemodynamic compromise.
- Further research into preventing and managing LAA device migration is warranted.
Abstract:
Left atrial appendage (LAA) occlusion device implantation is becoming a more common alternative for stroke prophylaxis in patients with nonvalvular atrial fibrillation (AF) who are not able to tolerate long-term anticoagulation. Studies suggest the procedure has a 98.5% successful deployment rate (Boersma et al., 2016). We present a case where a rare but known complication involving dislodgement and migration of an implanted Watchman LAA occlusion device led to functional stenosis of the aortic valve creating a left ventricular outflow tract (LVOT) obstruction necessitating emergency cardiopulmonary bypass in the electrophysiology lab to safely retrieve the device.
