Percutaneous Left Atrial Appendage Closure Using a PFO Occluder After an Incomplete Surgical Ligation.

The case regards a 73-year-old male who was referred for consideration of percutaneous left atrial appendage closure. His left atrial appendage was ligated during prior mitral valve surgery, but was noted to be patent on a recent transesophageal echocardiography. An Amulet device was selected based on CT planning. This report describes a challenging appendage anatomy unsuitable for the commercial devices, managed successfully with an off-label device.