Key result
Amplatzer Amulet device triggers late tissue erosion and acute tamponade at 14 months.
Why the study?
Identifying and managing complications of percutaneous left atrial appendage closure are paramount given the prophylactic nature of the procedure.
Case Report (n=1)
This case highlights the rare but severe risk of late device erosion and perforation up to 14 months after LAA closure with the Amplatzer Amulet device.
Late tamponade may occur >1 year after LAA closure; leaves open need for extended surveillance protocols.
BACKGROUND: Percutaneous left atrial appendage (LAA) closure may reduce the risk of cardioembolic stroke in patients with non-valvular atrial fibrillation. Given the prophylactic nature of the procedure, identifying and managing complications are paramount. CASE SUMMARY: A 73-year-old man presented 14 months after percutaneous LAA closure with syncope and acute pericardial tamponade which required surgical exploration and haemostasis; the most temporally remote account of this complication albeit amongst very few case reports. Tissue erosion by the Amplatzer™ Amulet™ LAA closure device (Abbott, Plymouth, MN, USA) was noted at two separate anatomical locations, corresponding to the device disc and lobe, which has not been described previously. DISCUSSION: This case report highlights the anatomical relationship between the LAA and its surrounding structures, and the importance of recognizing the risk of late device erosion.
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Wilkins et al. (2020) conducted a case report in non-valvular atrial fibrillation (n=1). Amplatzer™ Amulet™ LAA closure device was evaluated on late device erosion and perforation. Late tissue erosion and acute pericardial tamponade occurred 14 months after percutaneous left atrial appendage closure with an Amplatzer Amulet device in a 73-year-old man.
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