Snare-based percutaneous retrieval with coaxial sheath-assisted extraction successfully recovered embolized left atrial appendage and peri-device leak occluders without surgery.
Percutaneous retrieval of embolized LAAO and peri-device leak closure devices is feasible and can avoid surgical intervention when using structured snare-based techniques.
Absolute Event Rate: 0% vs 0%
BACKGROUND: Percutaneous LAAO is an established stroke-prevention strategy in atrial fibrillation patients unsuitable for long-term anticoagulation. Device embolization is uncommon but can cause severe complications requiring urgent intervention. ABSTRACT OF THE CASE: We report 2 related cases of device embolization associated with left atrial appendage occlusion and subsequent peri-device leak closure. The first involved early Amulet occluder embolization with mitral inflow obstruction and hemodynamic instability. The second occurred during peri-device leak closure after prior WATCHMAN implantation, when a 6 × 4-mm vascular occluder embolized upon release. In both cases, intraprocedural transesophageal echocardiography and fluoroscopy guided successful snare-based percutaneous retrieval with coaxial sheath-assisted extraction, avoiding surgery. Both devices were retrieved intact without major complications. CONCLUSIONS: Percutaneous retrieval of embolized LAAO devices is achievable with systematic planning and multidisciplinary preparedness. Growing LAAO volumes and leak reinterventions underscore the need for structured embolization rescue protocols.
David et al. (Mon,) reported a other. Snare-based percutaneous retrieval with coaxial sheath-assisted extraction successfully recovered embolized left atrial appendage and peri-device leak occluders without surgery.