Watchman Device Dislodgement Creating a Left Ventricular Outflow Tract Obstruction Requiring Emergency Cardiopulmonary Bypass.
Alex RobertsSteven MachJason GoebelHeather PalominoDerek HorstemeyerPublished in: Case reports in anesthesiology (2022)
Left atrial appendage (LAA) occlusion device implantation is becoming a more common alternative for stroke prophylaxis in patients with nonvalvular atrial fibrillation (AF) who are not able to tolerate long-term anticoagulation. Studies suggest the procedure has a 98.5% successful deployment rate (Boersma et al., 2016). We present a case where a rare but known complication involving dislodgement and migration of an implanted Watchman LAA occlusion device led to functional stenosis of the aortic valve creating a left ventricular outflow tract (LVOT) obstruction necessitating emergency cardiopulmonary bypass in the electrophysiology lab to safely retrieve the device.
Keyphrases
- left atrial appendage
- atrial fibrillation
- aortic valve
- left atrial
- catheter ablation
- left ventricular
- aortic stenosis
- oral anticoagulants
- heart failure
- direct oral anticoagulants
- transcatheter aortic valve replacement
- public health
- emergency department
- aortic valve replacement
- transcatheter aortic valve implantation
- healthcare
- percutaneous coronary intervention
- cardiac resynchronization therapy
- hypertrophic cardiomyopathy
- ejection fraction
- coronary artery disease
- acute coronary syndrome