Percutaneous management of late leak after lariat transcatheter ligation of the left atrial appendage in patients with atrial fibrillation at high risk for stroke.
Left atrial appendage (LAA) occlusion or ligation is a novel approach to stroke prevention in atrial fibrillation that may obviate the need for long-term anticoagulation. The Lariat device has received Food and Drug Administration 510K clearance for the approximation of soft tissue and has been applied to transcatheter LAA ligation using a combined trans-pericardial and transseptal approach. The occurrence of late leak after transcatheter LAA ligation and its percutaneous management has not been previously reported. Herein, we report three cases of late leak with reconstitution of the LAA after initially successful Lariat closure, and present a simple percutaneous technique for leak closure.
Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California.
William J
WJ
Mosley
Michael R
MR
Smith
Matthew J
MJ
Price
D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
Lariat; atrial fibrillation; left atrial appendage; left atrial appendage occlusion; stroke; thromboembolism