Hyperdynamic Left Atrial Appendage May Increase the Risk of Perforation
During Left Atrial Appendage Closure-- A Case Series
Introduction: Delayed pericardial effusion following WATCHMAN FLX
implantation is not well understood. We present a case series of two
patients with hyperdynamic left atrial appendages (LAA) who developed
delayed pericardial effusions following WATCHMAN FLX™ implantation.
Methods: Successful left atrial appendage closure was performed in 2
patients with paroxysmal atrial fibrillation using the WATCHMAN FLX™
device. Both patients had hyperdynamic left atrial appendages noted
during their procedures. Intra-procedure course was uncomplicated.
Results: Delayed pericardial effusion occurred necessitating drainage in
both cases. Conclusion: While exact mechanisms remain unclear, sinus
rhythm and the presence of a hyperdynamic LAA may play a role.
Understanding the interaction of the appendage and the delivery system
may help to reduce the likelihood of this rare, but serious,
complication. Keywords: Atrial fibrillation; Left Atrial Appendage
Closure; Pericardial Effusion; Pericardiocentesis.