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Extracting a Malpositioned Occluder Device Using Endovascular Forceps
Sumon Roy1, Hooman Bakhshi2, Hamza Aziz2
1Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Cardiology, Boston Medical Center Health System, Boston, Massachusetts, USA.
JACC. Case Reports
|August 8, 2025
Summary
This case report details the successful retrieval of a malpositioned Watchman FLX device using an AngioVac catheter. The procedure allowed for a subsequent successful left atrial appendage occlusion (LAAO) with an Amulet device.
Area of Science:
- Interventional Cardiology
- Medical Device Technology
Background:
- Transcatheter left atrial appendage occlusion (LAAO) is a minimally invasive procedure.
- Device malposition is a rare but significant complication.
Purpose of the Study:
- To report a novel technique for retrieving a malpositioned LAAO device.
- To demonstrate successful LAAO after device retrieval.
Main Methods:
- A Watchman FLX device shifted after implantation.
- An AngioVac catheter and Raptor forceps were used to grasp and extract the Watchman FLX.
- A second LAAO procedure was performed with an Amulet device.
Main Results:
- The malpositioned Watchman FLX device was successfully retrieved intact using the AngioVac system.
- Successful LAAO was achieved with a replacement Amulet device.
Conclusions:
- The AngioVac catheter provides a viable option for LAAO device retrieval.
- Proceduralists must be prepared to manage high-risk complications like device malposition.
