Gilbert Paul, Hashmi Sami
HonorHealth Internal Medicine Residency Program, Scottsdale, Arizona.
HonorHealth Cardiovascular Disease Fellowship Program, Scottsdale, Arizona.
J Soc Cardiovasc Angiogr Interv. 2024 May 22;3(8):102147. doi: 10.1016/j.jscai.2024.102147. eCollection 2024 Aug.
Left atrial appendage closure devices reduce the risk of stroke in patients with nonvalvular atrial fibrillation while avoiding the risks associated with therapeutic anticoagulation. This significant value comes with additional unique risks associated with device implantation or surgical closure. We discuss an uncommon complication of Watchman device (Boston Scientific) implantation wherein an asymptomatic fistulous connection developed between the left atrial appendage and the left circumflex artery. Additionally, we review other documented cases of left atrial appendage fistulas and current management approaches for iatrogenic fistulous connections associated with procedural left atrial appendage closure.
左心耳封堵装置可降低非瓣膜性心房颤动患者的中风风险，同时避免治疗性抗凝相关的风险。这一显著价值伴随着与装置植入或手术封堵相关的其他独特风险。我们讨论了Watchman装置（波士顿科学公司）植入的一种罕见并发症，即左心耳与左旋支动脉之间形成了无症状的瘘管连接。此外，我们回顾了其他已记录的左心耳瘘管病例以及与左心耳程序性封堵相关的医源性瘘管连接的当前管理方法。
