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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Left atrial appendage occlusion with Watchman device after incomplete surgical ligation
  1. Ngoda Manongi1,
  2. Alexander Volodarskiy2 and
  3. Seth Goldbarg2
  1. 1Internal Medicine, NewYork-Presbyterian Queens, Flushing, New York, USA
  2. 2Cardiology, NewYork-Presbyterian Queens, Flushing, New York, USA
  1. Correspondence to Dr Ngoda Manongi; nmanongi{at}gmail.com

Abstract

Non-valvular atrial fibrillation (NVAF) is the most common cause of cardioembolic stroke. The left atrial appendage (LAA) is the major source of cardiac emboli in patients with NVAF. Anticoagulation (AC) is the standard of care for stroke prevention in atrial fibrillation (AF), but many patients are intolerant of AC. Surgical exclusion of the LAA may result in incomplete closure and is associated with an increased risk of embolism. We report a case of a woman in her 50s with a history of persistent AF, mitral valve prolapse s/p repair with surgical LAA exclusion, and multifocal haemorrhagic stroke presented for elective LAA closure who underwent a Watchman placement successfully. This case demonstrates that a percutaneous approach for occlusion of the LAA when surgical exclusion was incomplete may be feasible with appropriate planning. Clinical outcome data for this patient group are needed.

  • Arrhythmias
  • Pacing and electrophysiology

https://doi.org/10.1136/bcr-2022-251905

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    Footnotes

    • Contributors Conception or design of the work: NM and SG. Data collection: NM, AV SG. Data analysis and interpretation: NM, AV and SG. Drafting the article: NM and AV. Critical revision of the article: AV and SG. Final approval of the version to be published: NM, AV and SG.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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