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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left Atrium Compression by Iatrogenic Hematoma Due to Left Atrial Appendage Clipping in Open Coronary Artery Bypass
Ahmad Tabatabaeishoorijeh1, Albert Oh1, Ziyab K Sarfaraz2
1School of Engineering Medicine, Texas A&M University, Houston, Texas, US.
Insights
Left atrial appendage clipping prevents stroke in atrial fibrillation. A case report details a complication with the Medtronic Penditure clip, highlighting the need for anatomical awareness during cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Technology
Background:
- Left atrial appendage (LAA) clipping is a common procedure during open cardiac surgery to prevent stroke and embolization in patients with atrial fibrillation.
- Several devices, such as the AtriCure AtriClip and Medtronic Penditure clip, are available for LAA occlusion.
Abstract:
Left atrial appendage (LAA) clipping during open cardiac surgery is widely used for stroke and embolization prevention in atrial fibrillation. Various devices are available for this purpose, including the AtriCure AtriClip and the recently introduced Medtronic Penditure clip. We present a case of a 59-year-old male with multiple comorbidities, including chronic kidney disease and coronary artery disease, who underwent coronary artery bypass grafting with prophylactic LAA clipping using the Medtronic Penditure atrial clip. The procedure was complicated by an iatrogenic hematoma due to clip erosion into the atrioventricular groove, leading to left atrial tamponade and necessitating chest re-exploration. This case underscores the importance of understanding the structural interactions between different LAA occlusion devices and surrounding cardiac anatomy. Further evaluation is warranted to assess the safety profile of newer LAA occlusion devices and their impact on postoperative outcomes.
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