Related Experiment Video
Updated: May 4, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Simultaneous Closure of Left Atrial Appendage and Mitral Paravalvular Leak
Robert T Kay1, Prasham Dave1, Alice Moroni1
1St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Background:
An 81-year-old man with 2 prior mitral valve replacements developed recurrent symptomatic paravalvular leak (PVL) despite prior transcatheter closure with vascular plugs. He had ongoing heart failure hospitalizations and hemolytic anemia that limited uninterrupted anticoagulation in the setting of atrial fibrillation and high thromboembolic risk.
Case Summary:
The patient underwent a combined procedure with redo PVL closure and left atrial appendage occlusion. Given close anatomic proximity of the lateral PVL to the appendage ostium, a Watchman FLX Pro device was deployed to achieve both left atrial appendage occlusion and sealing of the lateral PVL. Postprocedure, mitral PVL resolved, hemolysis improved at 1-month follow-up, and PVL closure was durable on 3-month follow-up transesophageal echocardiography.
Discussion:
To our knowledge, this is the first report of Watchman device use for mitral PVL closure. In high-surgical risk patients with atrial fibrillation and bleeding limitations, this single-device strategy may simplify treatment and reduce the need for additional interventions.
Related Concept Videos
Mitral Stenosis I: Introduction
Mitral Valve Prolapse I: Introduction
Mitral Regurgitation I: Introduction
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral Valve Prolapse II: Assessment and Management
Mitral Stenosis III: Medical Management

