Related Experiment Video
Updated: Apr 29, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Remote Tamponade After Percutaneous Left Atrial Appendage Closure
Magdalene Au1, David Bobrowski2, Eslem Altin3
1Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
JACC. Case Reports
|April 4, 2025
Summary
Percutaneous left atrial appendage closure (LAAC) can rarely cause delayed hemorrhagic tamponade, a serious complication. Cardiac CT pre-screening may help identify patients at risk, especially those receiving nitinol plug devices.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous left atrial appendage closure (LAAC) is increasingly used for nonvalvular atrial fibrillation patients at high thromboembolic risk.
- Patients with contraindications or high bleeding risk with oral anticoagulation are candidates for LAAC.
Observation:
- A rare case of acute hemorrhagic tamponade occurred 7 months after LAAC.
- Intraoperative findings revealed device-related microperforation of the left atrial appendage (LAA) and adjacent pulmonary artery erosion.
Findings:
- Remote tamponade after LAAC is a rare (<1%) but potentially fatal complication.
- Nitinol plug devices are associated with a higher incidence of remote tamponade compared to nitinol cage devices.
Implications:
- Routine cardiac computed tomography (CT) and transesophageal echocardiography are recommended for preprocedural planning.
- Pre-screening can identify patients at risk for delayed tamponade, guiding device selection and management strategies.
- This vigilance is particularly crucial for nitinol plug devices.
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