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Updated: Sep 3, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous Retrieval of Left Atrial Appendage Closure Devices in Patients With Atrial Fibrillation: A Case Report
Saihua Wang1, Juhua Zhang2, Shuwen Hao1
1Department of Cardiology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
Insights
Retrieving dislodged left atrial appendage closure (LAAC) devices is challenging. This report details two successful percutaneous retrieval methods for LAAC devices misplaced during atrial fibrillation treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Retrieval
Background:
- Left atrial appendage closure (LAAC) is a common procedure for stroke prevention in patients with atrial fibrillation.
- Inadvertent malpositioning or embolization of LAAC devices can occur due to operator error or device mismatch.
- Retrieval of malpositioned LAAC devices presents significant technical challenges.
Observation:
- Two cases of LAAC device malposition are presented.
- Case A: A LAAC device embolized to the aortic arch.
- Case B: A LAAC device was dislodged within the left atrium.
Findings:
- The aortic arch-dislodged LAAC device was successfully retrieved percutaneously via the femoral artery.
- The left atrium-dislodged LAAC device was retrieved using atrial transseptal puncture via the femoral vein.
- Both retrieval techniques were effective in managing device malposition.
Implications:
- Percutaneous retrieval is a feasible option for managing malpositioned LAAC devices.
- Successful retrieval minimizes risks associated with unretained devices.
- These cases highlight the importance of careful device selection and procedural technique in LAAC.
Abstract:
Left atrial appendage closure (LAAC) devices can be inadvertently released into unfavorable locations, which may allow them to migrate to a different position within the left atrial appendage or embolize from the heart into the aorta. In such instances, it can be challenging to remove the LAAC device. Here, we present two cases in which patients with atrial fibrillation experienced LAAC device exposure at an inappropriate site because of interventional operator error and device mismatch: (a) the LAAC device was dislodged into the aortic arch and retrieved percutaneously from the femoral artery route, and (b) in the left atrium, which was dislodged into the left atrium and retrieved via atrial transseptal puncture of the femoral vein.
