Closing gigantic left atrial appendage using a LAmbre Closure System: First implant experience in North America.

INTRODUCTION

Despite maturing experience and growing procedural familiarity, there remain challenges in percutaneous left atrial appendage (LAA) closure due to anatomical complexities.

METHODS

We report a complex and extremely large LAA that was successfully closed percutaneously using a LAmbre Closure System (Lifetech Scientific Corp.). Cardiac computed tomography angiography demonstrated a gigantic multilobed LAA measuring 48 × 45.3 mm at the level of the ostium that cannot be occluded by the currently approved LAA closure devices in Canada.

RESULTS

The manufacturer custom-made a LAmbre 30/50 mm (lobe/disc) device to fit this patient's LAA according to his CTA, which was successfully deployed under fluoroscopy and transesophageal echocardiogram guidance without procedure-related complications.

CONCLUSION

The LAmbre device may be considered to close very large LAAs.