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Case Reports
. 2020 Oct 31;5(1):7-11.
doi: 10.1016/j.case.2020.09.007. eCollection 2021 Feb.

Vital Role of Transesophageal Echocardiographic Surveillance of a Left Atrial Appendage Perforation Complicating Attempted Percutaneous Appendage Occlusion

Edan Zitelny  1 , Ryan Brunetti  1 , Matthew Singleton  1 , Elijah Beaty  1 , Karl Richardson  1
Affiliations
Case Reports

Vital Role of Transesophageal Echocardiographic Surveillance of a Left Atrial Appendage Perforation Complicating Attempted Percutaneous Appendage Occlusion

Edan Zitelny et al. CASE (Phila). .
No abstract available

Keywords: Atrial fibrillation; Cardiac tamponade; Complication; Pericardial effusion; Watchman.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Midesophageal TEE image of guiding catheter in the LAA, which has a chicken-wing morphology. LA, Left atrium.
Figure 2
Figure 2
Midesophageal TEE image of the Watchman device malpositioned and incompletely expanded upon attempted deployment in the LAA. LA, Left atrium.
Figure 3
Figure 3
Midesophageal TEE image of the developing pericardial effusion (red arrow) noted following the third attempt of Watchman device placement. LA, Left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
Figure 4
Figure 4
TEE images of LAA perforation visualized by color Doppler flow from the LAA into the pericardial space (red arrows), seen in two midesophageal imaging planes, 129° and 68°. LV, Left ventricle.
Figure 5
Figure 5
Midesophageal TEE images of LAA perforation resolving, evidenced by decreased flow on color Doppler (red arrow) as well as the presence of a small thrombus (orange arrow) visualized at site of perforation.
Figure 6
Figure 6
Midesophageal TEE color Doppler images demonstrating the cessation of flow through the LAA perforation as well as the presence of thrombus (red arrow) in the pericardial space.
See this image and copyright information in PMC

References

    1. Schwartz R.S., Holmes D.R., Van Tassel R.A., Hauser R., Henry T.D., Mooney M. Left atrial appendage obliteration: mechanisms of healing and intracardiac integration. JACC Cardiovasc Interv. 2010;3:870–877. - PubMed
    1. Holmes D.R., Kar S., Price M.J., Whisenant B., Sievert H., Doshi S.K. Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014;64:1–12. - PubMed
    1. Reddy V.Y., Gibson D.N., Kar S., O'Neill W., Doshi S.K., Horton R.P. Post-approval U.S. experience with left atrial appendage closure for stroke prevention in atrial fibrillation. J Am Coll Cardiol. 2017;69:253–261. - PubMed
    1. Svendsen J.H., Nielsen J.C., Darkner S., Jensen G.V., Mortensen L.S., Andersen H.R. CHADS2 and CHA2DS2-VASc score to assess risk of stroke and death in patients paced for sick sinus syndrome. Heart. 2013;99:843–848. - PMC - PubMed
    1. Steinbeck G., Sinner M.F., Lutz M., Müller-Nurasyid M., Kääb S., Reinecke H. Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: a nationwide in-hospital analysis of administrative data for Germany in 2014. Eur Heart J. 2018;39:4020–4029. - PMC - PubMed

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