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Updated: Sep 22, 2025
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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Case Report: WATCHMAN Procedure Complicated By Atrial Perforation and Device Dislodgement
Dina Al Rameni1, Ismael Salas de Armas1, Aon Al Rameeni2
1Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston, 6400 Fannin, Suite 2350, Houston, TX 77030, United States of America.
Summary
Atrial perforation after WATCHMAN™ FLX device deployment can lead to dislodgement. Minimizing left atrial manipulation during surgical repair and using transesophageal echocardiography are crucial for managing this complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Technology
Background:
- Percutaneous left atrial appendage exclusion is used to prevent stroke.
- Complications include atrial perforation and device dislodgement.
- WATCHMAN™ FLX is a common device for this procedure.
Observation:
- A case of atrial perforation occurred post-WATCHMAN™ FLX deployment.
- Surgical repair required heart manipulation, causing device dislodgement.
- The dislodged device was removed, and the left atrial appendage was resected and closed.
Findings:
- Minimal manipulation of the left atrium during surgical exploration is vital to prevent device dislodgement.
- Intraoperative transesophageal echocardiography is essential for monitoring device position and detecting dislodgement.
Implications:
- This case highlights the importance of careful surgical technique during left atrial appendage procedures.
- Standardizing monitoring protocols with transesophageal echocardiography can improve patient outcomes.
- Further research into device stability and management of rare complications is warranted.
