Saleem Naaemah, Duran Cihan
Federal Medical College, Islamabad, Pakistan.
Department of Diagnostic Radiology, University of Texas Health Science Centre at Houston, Houston, TX, USA.
Radiol Case Rep. 2025 Jul 7;20(9):4840-4843. doi: 10.1016/j.radcr.2025.05.033. eCollection 2025 Sep.
Left atrial appendage occlusion (LAAO) is an alternative to anticoagulation for atrial fibrillation patients at high thromboembolic risk, but device embolization, though rare, can be life-threatening and may require percutaneous retrieval or surgery. We present the case of an 82-year-old male who underwent successful Watchman device implantation for stroke prevention; however, follow-up echocardiography revealed embolization into the left ventricular outflow tract (LVOT), necessitating urgent retrieval. The device was safely removed percutaneously using an ONO basket without complications, and the patient later underwent successful repeat LAA closure with an Amulet device, confirmed by transesophageal echocardiography (TEE). This case highlights the feasibility of percutaneous retrieval using an ONO basket, the importance of early detection of device embolization, and a minimally invasive approach that allows for subsequent successful LAA closure.
左心耳封堵术(LAAO)是高血栓栓塞风险房颤患者抗凝治疗的替代方案,但器械栓塞虽罕见,却可能危及生命,可能需要经皮取出或手术治疗。我们报告一例82岁男性患者,其接受了成功的Watchman器械植入以预防中风;然而,随访超声心动图显示器械栓塞至左心室流出道(LVOT),需要紧急取出。使用ONO网篮经皮安全取出器械,无并发症发生,患者随后使用Amulet器械成功再次封堵左心耳,经食管超声心动图(TEE)证实。该病例强调了使用ONO网篮经皮取出器械的可行性、器械栓塞早期检测的重要性,以及允许随后成功封堵左心耳的微创方法。