Retrieval of embolized left atrial appendage devices

Peter Fahmy; L. Eng; Jacqueline Saw

doi:10.1002/ccd.26800

September 28, 2016Catheterization and Cardiovascular Interventions

Retrieval of embolized left atrial appendage devices

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Structured PICO

P

Population

2 patients with embolized left atrial appendage (LAA) devices (ACP/AMULET and WATCHMAN)

I

Intervention

Percutaneous retrieval techniques

O

Outcome

Successful percutaneous retrieval

Percutaneous retrieval of embolized LAA devices is feasible and provides a minimally invasive management option for this complication.

Implication

Supports feasibility of percutaneous retrieval for embolized LAA devices; hypothesis-generating and should not yet change practice.

Abstract

Percutaneous left atrial appendage (LAA) closure is gaining interest as an alternative option for prevention of strokes in patients with Atrial Fibrillation (AF), especially for those with contraindications to anticoagulation. Complications from these procedures are well described in the medical literature. LAA closures may lead to pericardial effusion, device-associated thrombus, and device embolization. Understanding the reasons for embolization, strategies to avoid embolization, and the techniques for retrieval of LAA devices (ACP/AMULET and WATCHMAN) should be appreciated by endovascular implanters. We describe two cases of LAA device embolization that were both successfully retrieved percutaneously and other percutaneous techniques to safely retrieve embolized LAA devices.