title: Percutaneous management of left atrial appendage perforation during device closure.
abstract: A 76-year-old male patient was admitted for percutaneous left atrial appendage (LAA) closure because of chronic atrial fibrillation and a history of gastrointestinal bleeding under oral anticoagulation. The procedure was complicated by perforation of the LAA with the lobe of the closure device being placed in the pericardial space. Keeping access to the pericardial space with the delivery sheath, the LAA closure device was replaced by an atrial septal defect closure device to seal the perforation. Then the initial LAA closure device was reimplanted in a correct position. Needle pericardiocentesis was required but the subsequent course was uneventful.
authors.affiliation: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Sergio G
authors.initials: SG
authors.lastname: Tarbine
authors.forename: Costantino R
authors.initials: CR
authors.lastname: Costantini
mesh_terms: D020517:Atrial Appendage / Q000293:injuries; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D062906:Cardiac Catheters; D004867:Equipment Design; D006335:Heart Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D020519:Pericardiocentesis; D015641:Radiography, Interventional; D055989:Septal Occluder Device; D016896:Treatment Outcome
keywords: closure; left atrial appendage; left atrium; perforation