Key result
Endoscopic grasping tool enables safe percutaneous retrieval and reimplantation of a migrated WATCHMAN device.
Why the study?
Left atrial appendage closure devices may rarely migrate chronically to unfavorable positions postoperatively, necessitating removal.
Case Report (n=1)
No
This case demonstrates the feasibility of percutaneous extraction of a chronically migrated left atrial appendage closure device using an endoscopic grasping tool and temporary aortic protection.
Case supports technical feasibility of endoscopic extraction for migrated WATCHMAN; leaves open generalizability and safety in larger cohorts.
Rarely, a left atrial appendage closure device may chronically migrate to an unfavorable position postoperatively, requiring removal. We present the details of a case in which a WATCHMAN™ device (Boston Scientific, Natick, MA, USA) implanted seven months prior was found to have migrated with protrusion 0.91 cm outside the left atrial appendage together with a 90º tilt and peridevice leakage. Adopting a femoral arterial retrograde approach, a 27-mm WATCHMAN™ device was temporarily positioned in the ascending aorta for cerebroembolic protection, never released from the connecting wire. Extraction of the original WATCHMAN™ device was performed using an endoscopic grasping tool, with subsequent device re-implantation of a new device and removal of the temporarily positioned device in the ascending aorta.
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Maan et al. (2021) conducted a case report in Migrated WATCHMAN device / Atrial fibrillation (n=1). Percutaneous extraction using an endoscopic grasping tool was evaluated on Procedural success (device extraction and reimplantation). Percutaneous extraction of a chronically migrated WATCHMAN device using an endoscopic grasping tool and temporary embolic protection in the ascending aorta was safely and successfully performed.
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