Percutaneous Retrieval of Embolized Left Atrial Appendage Occlusion Device From Mitral Valve Apparatus.

BACKGROUND

Left atrial appendage occlusion (LAAO) is a safe and effective intervention for patients with atrial fibrillation who are unable to tolerate anticoagulation. Despite the safety of the procedure, complications including device displacement are a potential risk.

CASE SUMMARY: A frail 84-year-old man underwent LAAO implantation, which was complicated by an early device displacement into the mitral apparatus, precipitating myocardial infarction and cardiogenic shock. The device was retrieved percutaneously with 2 snare wires, with a good patient recovery on follow-up.

DISCUSSION: Device displacement to the mitral apparatus is a rare complication with high mortality. Transcatheter device retrieval is feasible with the right skills and equipment with good final results.

TAKE-HOME MESSAGES: Early dislodgement of LAAO devices, though rare, can cause acute mitral valve obstruction and cardiogenic shock. Mechanical obstruction and ischemic events may coexist, necessitating rapid multimodality imaging and parallel management strategies.