Retrieval of Embolized WATCHMAN® Flex Atrial Appendage Occlusion Device

Author:

Chugh Priyanka V.1ORCID,Danford Julia2,Farber Alik1,Ayalon Nir3,Verma Ashish4,Helm Robert H.5,Monahan Kevin M.5,Kalish Jeffrey A.1

Affiliation:

1. Department of Surgery, Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

2. Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

3. Evans Department of Medicine, Cardiovascular Medicine Section, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

4. Evans Department of Medicine, Renal Section, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

5. Evans Department of Medicine, Cardiovascular Medicine Section, Arrhythmia Service, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

Abstract

This case report documents the management of a 66-year old man with atrial fibrillation with recent placement of a WATCHMAN® Flex atrial appendage occlusion device. The patient presented with renal failure, abdominal pain, and difficulty walking 2 months after placement. The WATCHMAN® Flex device was found to have embolized to his abdominal aorta at the level of the renal arteries with associated thrombus. Extensive workup revealed reduced left ventricular cardiac function and decreased renal function, both of which were felt to be potentially reversible with device removal. The patient then underwent retrieval of the device and all associated thrombus via an open retroperitoneal approach. This case demonstrates a potential consequence of implanting devices such as an atrial appendage occlusion device and describes a technique for removal.

Publisher

SAGE Publications

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