Key result
Rapid release of LAA closure device with pericardial evacuation successfully manages tamponade without surgery.
Why the study?
Left atrial appendage perforation is a possible complication during percutaneous LAA closure, requiring prompt management to avoid surgery.
Case Report (n=1)
Rapid deployment of an LAA closure device combined with pericardiocentesis can successfully manage iatrogenic LAA perforation and cardiac tamponade, avoiding the need for emergency surgery.
Alerts to perforation risk during diagnostic LAA sheath positioning; single case leaves open optimal preventive techniques.
Left atrial appendage (LAA) perforation is a possible complication not only after release of the closure device, but also during the diagnostic phase due to sheath positioning in the LAA. We present an 83-year-old woman with permanent atrial fibrillation and high thromboembolic and bleeding risk who was admitted for elective percutaneous LAA closure. During angiographic study, she suddenly became hypotensive. Heart perforation with leakage of contrast in the pericardial space was evident and imaging confirmed cardiac tamponade. Rapid release of the closure device and pericardial evacuation allowed the operators to successfully manage the cardiac tamponade and avoid a surgical option.
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Lorenzoni et al. (2018) conducted a case report in Left atrial appendage perforation during percutaneous closure (n=1). Rapid release of the closure device and pericardial evacuation was evaluated on Management of cardiac tamponade and avoidance of surgery. Rapid release of the closure device and pericardial evacuation successfully managed cardiac tamponade following left atrial appendage perforation, avoiding the need for surgery.
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