Key result
Watchman implantation perforation can necessitate emergency sternotomy with cardiopulmonary bypass.
Why the study?
Percutaneous left atrial appendage occlusion is increasingly used for stroke prevention in non-valvular atrial fibrillation patients at high risk from long-term anticoagulation, but complications such as appendage perforation require surgical management strategies.
Case Report (n=1)
Highlights technical considerations for emergency surgical repair of left atrial appendage perforation during percutaneous occlusion procedures.
Demands surgical bailout readiness during Watchman implantation; leaves open optimal techniques to prevent LAA perforation.
Percutaneous occlusion of the left atrial appendage is increasingly being used as an alternative for stroke prevention in patients with non-valvular atrial fibrillation at high risk of complications from long term anticoagulation. We describe a case of left atrial appendage perforation during Watchman device implantation requiring emergency repair of the left atrium using sternotomy and cardiopulmonary bypass. Technical considerations for surgical decision making are discussed; in hemodynamically unstable patients as well as those at high risk for embolization.
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Masroor et al. (2020) conducted a case report in Non-valvular atrial fibrillation / Left atrial appendage perforation (n=1). Watchman device implantation was evaluated on Left atrial appendage perforation requiring emergency repair. Left atrial appendage perforation during Watchman device implantation can require emergency surgical repair using sternotomy and cardiopulmonary bypass.
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