Percutaneous Retrieval of Free-Floating Amulet Device From Left Atrium

Atrial fibrillation (AF) is a common cardiac arrhythmia, significantly increasing the risk of thromboembolic events, particularly cerebral vascular accidents. Left atrial appendage occluder devices have been introduced as an alternative to anticoagulation therapy for stroke prevention in AF patients, but their use can be complicated by device embolization. This report details the case of an 81-year-old woman with persistent AF, chronic immune thrombocytopenic purpura, and various other comorbidities, who underwent a left atrial appendage closure using an Amulet device. Despite the successful initial placement, a subsequent transthoracic echocardiogram revealed device embolization within the left atrium. A percutaneous retrieval was successfully performed using an Amplatz Gooseneck Snare and a MitraClip transseptal sheath via the right femoral vein. The occurrence of device embolization, although rare (incidence approximately 0.07%), necessitates a multidisciplinary approach for effective management. Percutaneous retrieval of an embolized left atrial appendage closure device from the left atrium is feasible by a transseptal approach.