Key result
Late WATCHMAN embolization to the abdominal aorta triggers fatal aortic occlusion and multisystem organ failure.
Case Report (n=1)
This case highlights the critical need for emergency physicians to consider left atrial appendage closure device embolization in patients with a history of recent implantation who present with sudden unexplained neurologic deficits or ischemia.
Answers are grounded in this paper and cite their sources.
May warrant considering embolization in recent WATCHMAN recipients with acute ischemia; case report leaves open incidence and prevention.
We present a case study involving an elderly patient who experienced dislodgement of a recently implanted WATCHMAN device. Initially, the patient exhibited multiple musculoskeletal symptoms, which raised concerns about alternative causes such as cauda equina syndrome or spinal epidural hematoma. Despite vascular surgery removing the device, the patient's condition deteriorated due to ischemia leading to multisystem organ failure. This case highlights the critical need for emergency physicians to promptly diagnose acute aortic obstruction caused by embolization, given the increasing use of the WATCHMAN device in the aging population to reduce the reliance on anticoagulation. The potential for significant ischemic consequences necessitates immediate intervention to mitigate complications.
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Blanchard et al. (2023) conducted a case report in WATCHMAN device embolization (n=1). WATCHMAN device was evaluated. An elderly patient with a recently implanted WATCHMAN device experienced late embolization to the abdominal aorta, leading to bilateral lower extremity paralysis and fatal multisystem organ failure.
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