Halim Jonathan, Tavernier Rene, Missault Luc, Debonnaire Philippe
Department of Cardiology, Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
Eur Heart J Case Rep. 2020 Jul 9;4(4):1-4. doi: 10.1093/ehjcr/ytaa161. eCollection 2020 Aug.
Embolization of a Watchman device in patients undergoing percutaneous left atrial appendage (LAA) closure is a rare complication. Retrieval of the device can be achieved percutaneously with a snaring technique or a bioptome.
We present an illustrative case of Watchman closure device embolization during an LAA closure attempt in a 77-year-old man. The complication was caused by anatomical restraints of the LAA, in particular limited depth resulting in poor stability of the closure device after implantation. By the use of a double snaring technique, however, we managed to retrieve the device percutaneously. By applying such strategy, a more invasive surgical approach can be prevented.
Prompt response is needed when embolization of a Watchman device occurs. A snaring technique can be used in most cases to attempt device retrieval. A double snaring technique is in this case associated with higher retrieval success than a single snaring technique.
在接受经皮左心耳（LAA）封堵术的患者中，Watchman装置栓塞是一种罕见的并发症。可通过圈套技术或活检钳经皮取出该装置。
我们展示了一名77岁男性在LAA封堵尝试过程中Watchman封堵装置栓塞的典型病例。该并发症是由LAA的解剖限制引起的，特别是深度有限，导致植入后封堵装置稳定性差。然而，通过使用双重圈套技术，我们成功地经皮取出了该装置。通过应用这种策略，可以避免采用更具侵入性的手术方法。
Watchman装置发生栓塞时需要迅速做出反应。在大多数情况下，可以使用圈套技术尝试取出装置。在这种情况下，双重圈套技术比单一圈套技术的取出成功率更高。
