Redo Left Atrial Appendage Closure With a Different Device After Initial Dislodgement

首次脱位后使用不同装置再次进行左心耳封堵术

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Abstract

BACKGROUND: Atrial fibrillation (AF) often requires long-term anticoagulation to reduce thromboembolic risk, but limitations, such as poor compliance and bleeding risks, make left atrial appendage closure (LAAC) a key alternative. Device dislodgment is a rare but critical LAAC complication, with limited data on successful retrieval and subsequent reimplantation. CASE SUMMARY: A 72-year-old male patient with AF (CHA(2)DS(2)-VASc score: 5, HAS-BLED score: 3) underwent LAAC with a LAmbre occluder, which dislodged perioperatively. The device was successfully retrieved percutaneously, followed by reimplantation of a Watchman occluder without complications. Postprocedure imaging confirmed proper positioning. DISCUSSION: This is the first report of successful percutaneous retrieval of a dislodged LAmbre occluder and subsequent reimplantation of an alternative device, addressing both the complication of LAAC and the original indication for LAAC. TAKE-HOME MESSAGES: Percutaneous retrieval of a dislodged LAAC device with immediate reimplantation is feasible, offering a practical approach to managing such rare complications in high-risk patients with AF.

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