Percutaneous Retrieval Strategies Following Left Atrial Appendage Occluder and Peri-Device Leak Closure Embolization

Authors

• Wadie David, Henry Ford HealthFollow
• Ziad R. Affas, Henry Ford HealthFollow
• John Bajouka, Henry Ford HealthFollow
• Keyshla M. Pagan Morales, Henry Ford HealthFollow
• Herman Kado, Henry Ford Health

Recommended Citation

David W, Affas Z, Bajouka J, Morales KP, Kado H. Percutaneous Retrieval Strategies Following Left Atrial Appendage Occluder and Peri-Device Leak Closure Embolization. JACC Case Rep. 2026;31(32):108781.

Document Type

Article

Publication Date

8-12-2026

Publication Title

JACC Case Rep

Abstract

BACKGROUND: Percutaneous LAAO is an established stroke-prevention strategy in atrial fibrillation patients unsuitable for long-term anticoagulation. Device embolization is uncommon but can cause severe complications requiring urgent intervention.

ABSTRACT OF THE CASE: We report 2 related cases of device embolization associated with left atrial appendage occlusion and subsequent peri-device leak closure. The first involved early Amulet occluder embolization with mitral inflow obstruction and hemodynamic instability. The second occurred during peri-device leak closure after prior WATCHMAN implantation, when a 6 × 4-mm vascular occluder embolized upon release. In both cases, intraprocedural transesophageal echocardiography and fluoroscopy guided successful snare-based percutaneous retrieval with coaxial sheath-assisted extraction, avoiding surgery. Both devices were retrieved intact without major complications.

CONCLUSIONS: Percutaneous retrieval of embolized LAAO devices is achievable with systematic planning and multidisciplinary preparedness. Growing LAAO volumes and leak reinterventions underscore the need for structured embolization rescue protocols.

PubMed ID

42334395

Volume

31

Issue

32

First Page

108781

Last Page

108781