Goodyear Evelyn, Kunamalla Aaron, Ferro Enrico G, Modi Ronuk M, D'Avila Andre, Locke Andrew H, Liu David, Laham Roger J
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
JACC Case Rep. 2025 Jan 23;30(8):103186. doi: 10.1016/j.jaccas.2024.103186.
Although rare, embolization of left atrial appendage occlusion (LAAO) devices carries a significant morbidity and mortality burden.
An asymptomatic 77-year-old woman with inability to tolerate anticoagulation due to gastrointestinal bleeding presented for 45-day transesophageal echocardiography following LAAO with a Watchman device, which demonstrated incidental device migration to the left ventricular outflow tract (LVOT). Percutaneous extraction was performed using a novel technique with rat tooth/alligator forceps to successfully retrieve the Watchman from the LVOT using a transaortic approach.
LAAO device embolization is a rare, yet serious, complication. Retrieval from the LVOT is typically performed with cardiac surgery to avoid damage to the mitral valve. This case demonstrates that percutaneous Watchman device retrieval from the LVOT is technically challenging but can be safely performed in select cases to decrease the length of hospitalization and morbidity associated with surgery.
尽管罕见，但左心耳封堵（LAAO）装置的栓塞会带来严重的发病和死亡负担。
一名77岁无症状女性因胃肠道出血无法耐受抗凝治疗，在使用Watchman装置进行左心耳封堵术后45天接受经食管超声心动图检查，结果显示装置意外迁移至左心室流出道（LVOT）。采用一种新技术，使用鼠齿/鳄嘴钳经主动脉途径成功从LVOT取出Watchman装置。
LAAO装置栓塞是一种罕见但严重的并发症。通常通过心脏手术从LVOT取出装置以避免损伤二尖瓣。本病例表明，经皮从LVOT取出Watchman装置在技术上具有挑战性，但在某些特定情况下可以安全进行，以缩短住院时间并降低与手术相关的发病率。
