Percutaneous Removal of Left Atrial Appendage Occlusion Device With a Dedicated Retrieval System.

OBJECTIVE

Successful use of a novel percutaneous retrieval system (ŌNŌ retrieval system, ŌNŌCOR) to remove a significantly dislodged left atrial appendage occlusion device (Watchman FLX, Boston Scientific).

KEY STEPS: First, a 17-F Bayliss VersaConnect and TruSteer catheter was advanced through a 20-F DrySeal sheath (Gore Medical). Then, the ŌNŌ retrieval system was advanced and positioned against the Watchman FLX device. Through this system, a 2.4-mm Raptor forceps (Steris) was advanced to grab one of the struts on the Watchman device. Slow traction on the Raptor forceps and simultaneous advancement of the ŌNŌ basket was performed to dislodge the Watchman device from the left atrial appendage.

POTENTIAL PITFALLS: Device embolization, left atrial appendage avulsion, and pericardial effusion are some of the potential complications of the Watchman retrieval procedure.

TAKE-HOME MESSAGE: Embolization of a left atrial appendage occlusion device is a rare but potentially devastating complication, and percutaneous retrieval with the ŌNŌ system may provide a safer alternative to surgical removal.