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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Migration of the left atrial appendage closure device to the aorta

Susana González-Suárez1, José Carlos Sureda Barbosa2, María Sol Siliato Robles2

  • 1Department of Surgery, Department of Anesthesiology and Intensive Care, Cardiovascular diseases Research Group, Universitat Autònoma de Barcelona, Unitat Docent Vall d´Hebron, Vall d´Hebron University Hospital, Vall d´Hebron Institut de Recerca (VHIR), Passeig Vall d´Hebron 119-129, Barcelona, 08035, Spain. susana.gonzalez@uab.cat.

The International Journal of Cardiovascular Imaging
|June 21, 2024
PubMed

Insights

Left atrial appendage closure is an alternative to anticoagulation but can cause complications. Device migration led to severe aortic insufficiency, necessitating emergency cardiac surgery for removal.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Left atrial appendage (LAA) closure offers an alternative to long-term anticoagulation for patients with atrial fibrillation and contraindications to blood thinners, such as recurrent bleeding.
  • Percutaneous LAA closure devices aim to prevent stroke by sealing the LAA, a common source of emboli.

Observation:

  • A patient requiring LAA closure due to contraindications for anticoagulation therapy developed severe aortic insufficiency.
  • The complication was directly attributed to the migration of the implanted LAA closure device.

Findings:

  • Device migration is a rare but serious complication of percutaneous LAA closure.
  • Severe aortic insufficiency resulted from the displaced LAA closure device, posing an immediate threat to the patient's life.

Implications:

  • This case highlights the potential risks associated with LAA closure devices and the need for careful patient selection and monitoring.
  • Urgent surgical intervention may be required to manage device-related complications, emphasizing the importance of a multidisciplinary approach in managing atrial fibrillation patients.
  • Further research into device design and implantation techniques may be warranted to minimize migration risks.

Keywords:
Aortic insufficiencyAortic valveCardiac surgeryDevice migrationLeft atrial appendage closure device

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