Related Experiment Video
Updated: Jul 11, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left Circumflex Fistula After Watchman Implantation: A Case Report of Left Atrial Appendage Closure Complication
1HonorHealth Internal Medicine Residency Program, Scottsdale, Arizona.
Insights
Left atrial appendage closure devices, like the Watchman device, can cause rare fistulas between the heart and arteries. This review covers these uncommon complications and their management.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Left atrial appendage closure (LAAC) devices are used to prevent stroke in nonvalvular atrial fibrillation (NVAF) patients, offering an alternative to anticoagulation.
- While effective, LAAC procedures carry unique risks, including those related to device implantation or surgical closure.
Observation:
- An uncommon complication involving a Watchman device (Boston Scientific) implantation resulted in an asymptomatic fistulous connection between the left atrial appendage and the left circumflex artery.
- This case highlights a rare but significant iatrogenic complication associated with LAAC procedures.
Findings:
- The study reviews documented cases of left atrial appendage fistulas following LAAC.
- It also examines current management strategies for these iatrogenic vascular connections.
Implications:
- Understanding and recognizing these rare fistulas is crucial for timely diagnosis and appropriate management.
- This review contributes to the safe application of LAAC technology in clinical practice.
Abstract:
Left atrial appendage closure devices reduce the risk of stroke in patients with nonvalvular atrial fibrillation while avoiding the risks associated with therapeutic anticoagulation. This significant value comes with additional unique risks associated with device implantation or surgical closure. We discuss an uncommon complication of Watchman device (Boston Scientific) implantation wherein an asymptomatic fistulous connection developed between the left atrial appendage and the left circumflex artery. Additionally, we review other documented cases of left atrial appendage fistulas and current management approaches for iatrogenic fistulous connections associated with procedural left atrial appendage closure.
