BMJ Case Reports 2018; doi:10.1136/bcr-2018-227098
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Delayed presentation of pulmonary artery perforation by an Amulet left atrial appendage closure device

  1. Chris Merry1
  1. 1Department of Cardiothoracic Surgery and Transplantation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  2. 2Department of Cardiology and Transplantation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  1. Correspondence to Dr Edward Wang, Edward.Wang{at}
  • Accepted 16 October 2018
  • Published 3 November 2018


Left atrial appendage occlusion (LAAO) devices offer stroke prevention in atrial fibrillation for patients intolerant of anticoagulation. Device placement leading to bleeding and cardiac tamponade have been reported periprocedurally but delayed presentations have not been reported in the literature. We present the case of an Amulet LAAO device causing erosion and bleeding from the main pulmonary artery that presented with cardiac tamponade 6 months after device placement. The pulmonary artery defect was repaired primarily and buttressed with a pericardial patch with good result.


  • Contributors EW authored the paper. WWL proofread the paper. XFX assisted with acquiring imaging and theorising a causative factor for the complication. CM was the surgeon in charge and proofread the paper.

  • Funding No sponsors or funding was sought for this project

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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