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Updated: Jun 26, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Retrieval of Embolized WATCHMAN® Flex Atrial Appendage Occlusion Device
Priyanka V Chugh1, Julia Danford2, Alik Farber1
1Department of Surgery, Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Insights
A WATCHMAN Flex device embolized to the abdominal aorta after atrial fibrillation treatment. Successful retrieval via surgery restored cardiac and renal function, highlighting a rare complication and removal technique.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Atrial fibrillation necessitates stroke prevention, often managed with anticoagulants or left atrial appendage occlusion (LAAO) devices.
- The WATCHMAN Flex is an LAAO device designed to reduce stroke risk in patients with atrial fibrillation.
- Device embolization is a rare but serious complication associated with LAAO procedures.
Observation:
- A 66-year-old male presented with renal failure, abdominal pain, and gait disturbance two months post-WATCHMAN Flex implantation.
- Imaging revealed the WATCHMAN Flex device had embolized to the abdominal aorta near the renal arteries, accompanied by thrombus formation.
- The patient exhibited reduced left ventricular function and compromised renal function.
Findings:
- The embolized WATCHMAN Flex device and associated thrombus were successfully retrieved using an open retroperitoneal surgical approach.
- Post-retrieval, the patient's cardiac and renal functions showed potential for reversibility.
- This case highlights a significant complication of LAAO device implantation.
Implications:
- This case underscores the importance of vigilance for rare device-related complications following LAAO procedures.
- The successful open surgical retrieval technique provides a potential management strategy for similar cases of device embolization.
- Further research into long-term outcomes and prevention of LAAO device migration is warranted.
Abstract:
This case report documents the management of a 66-year old man with atrial fibrillation with recent placement of a WATCHMAN® Flex atrial appendage occlusion device. The patient presented with renal failure, abdominal pain, and difficulty walking 2 months after placement. The WATCHMAN® Flex device was found to have embolized to his abdominal aorta at the level of the renal arteries with associated thrombus. Extensive workup revealed reduced left ventricular cardiac function and decreased renal function, both of which were felt to be potentially reversible with device removal. The patient then underwent retrieval of the device and all associated thrombus via an open retroperitoneal approach. This case demonstrates a potential consequence of implanting devices such as an atrial appendage occlusion device and describes a technique for removal.
