Left atrial appendage perforation during appendage angiography treated by percutaneous left atrial appendage closure: a case report

Abstract Background Pericardial effusion is a common complication of percutaneous left atrial appendage (LAA) closure. Acute management is the cornerstone of pericardial effusion treatment and interrupting the intervention is often required. Case summary A 65-year-old man presented an acute 10 mm pericardial effusion following pigtail contrast appendage injection. A rapid Watchman Flex 24 mm (Boston Scientific) deployment permitted bleeding interruption. A needle pericardiocentesis was achieved in order to prevent any haemodynamical instability. Discussion This case report describes an atypical cause of pericardial effusion and a technique for bleeding control with LAA closure device deployment.

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Late embolization of left atrial appendage closure device – case report

Cardiologia Croatica ◽

10.15836/ccar2016.416 ◽

2016 ◽

Vol 11 (10-11) ◽

pp. 416-416

Author(s):

Luka Bastiančić ◽

Ivana Smoljan ◽

Tomislav Jakljević ◽

Sandro Brusich ◽

Vjekoslav Tomulić ◽

...

Keyword(s):

Case Report ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Closure Device ◽

Left Atrial Appendage Closure

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Late presentation of left atrial appendage erosion and perforation by an Amplatzer™ Amulet™ closure device: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa079 ◽

2020 ◽

Vol 4 (3) ◽

pp. 1-5

Author(s):

Ben Wilkins ◽

Christian L Carranza ◽

Lars Søndergaard ◽

Ole De Backer

Keyword(s):

Case Report ◽

Left Atrial ◽

Left Atrial Appendage ◽

Case Reports ◽

Late Presentation ◽

Pericardial Tamponade ◽

Atrial Appendage ◽

Closure Device ◽

Anatomical Relationship ◽

Laa Closure

Abstract Background Percutaneous left atrial appendage (LAA) closure may reduce the risk of cardioembolic stroke in patients with non-valvular atrial fibrillation. Given the prophylactic nature of the procedure, identifying and managing complications are paramount. Case summary A 73-year-old man presented 14 months after percutaneous LAA closure with syncope and acute pericardial tamponade which required surgical exploration and haemostasis; the most temporally remote account of this complication albeit amongst very few case reports. Tissue erosion by the Amplatzer™ Amulet™ LAA closure device (Abbott, Plymouth, MN, USA) was noted at two separate anatomical locations, corresponding to the device disc and lobe, which has not been described previously. Discussion This case report highlights the anatomical relationship between the LAA and its surrounding structures, and the importance of recognizing the risk of late device erosion.

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Left atrial appendage closure device complicated by late-onset pericardial effusion and tamponade: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab058 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

Stefano Albani ◽

Nicola Berlier ◽

Francesco Pisano ◽

Paolo Scacciatella

Keyword(s):

Pericardial Effusion ◽

Left Atrial ◽

Left Atrial Appendage ◽

Late Onset ◽

Oral Anticoagulants ◽

Bleeding Risk ◽

Atrial Appendage ◽

Closure Device ◽

Device Implantation ◽

First Case

Abstract Background Late-onset complications of left atrial appendage occlusion (LAAO) device procedure are anecdotal and there are no such complications reported in literature using Cardia Ultraseal (Cardia, Inc., Eagan, MN, USA). Case summary We report the case of a 74-year-old Caucasian man affected by paroxysmal atrial fibrillation with significant bleeding risk (familiar thrombocytopenia, macroscopic haematuria episodes during therapy with direct oral anticoagulants, HAS-BLED risk score: 4) and ischaemic risk as well (CHADSVASC score: 3). The patient was treated with LAAO device implantation for high bleeding risk. Subsequently, after 26 days from LAAO procedure, he was admitted to the emergency department for haematic cardiac tamponade. The patient was successfully treated with subxyphoidal pericardiocentesis in the acute phase, unfortunately cardiac arrest occurred during the transfer to the referral hospital for urgent cardiac surgery. Permanent neurological damage was reported and the patient died on day 28. Discussion LAAO late-onset complications are very rare and the case presented is the first case described of late-onset pericardial effusion and tamponade secondary to the Cardia Ultraseal LAAO device implantation. We present a revision of the literature regarding the occurrence of similar adverse events and discuss the hypothetical mechanism of this major complication.

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