WATCHMAN Gone Astray, Catastrophic Mitral Regurgitation Following Device Dislodgement

Figures

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  Figure 1. Midesophageal 2-chamber view showing the dislodged WATCHMAN device in the left atrium. LA = Left atrium, LAA = Left atrial appendage, LV = Left ventricle, MV = Mitral valve

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  Figure 2. Left image: Midesophageal five-chamber view showing the WATCHMAN device lodged in the mitral valve subvalvular apparatus. Right image: Midesophageal two-chamber view obtained through biplane imaging of the five-chamber view, again showing the WATCHMAN device lodged in the mitral valve subvalvular apparatus. AV = Aortic valve, LA = Left atrium, LV = Left ventricle, MV = Mitral valve, RV = Right ventricle

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  Figure 3. Midesophageal long axis view with color Doppler showing the resulting acute severe mitral regurgitation. AV = Aortic valve, LA = Left atrium, LV = Left ventricle, MR = Mitral regurgitation, MV = Mitral valve, RV = Right ventricle. Echo Clip 1: Midesophageal two-chamber view displaying the WATCHMAN device that has become dislodged and is now floating in the left atrium. Echo Clip 2: Midesophageal five- and two-chamber views showing the WATCHMAN device lodged within the MV subvalvular apparatus, preventing the MV leaflets from coapting. MV = mitral valve. Echo Clip 3: Midesophageal long axis with color Doppler showing severe MR caused by the dislodged WATCHMAN device. MR = Mitral regurgitation