Percutaneous retrieval of an embolized left atrial appendage closure device from the left atrium in a patient with previous MitraClips

BACKGROUND: Left atrial appendage closure is increasingly used. LAA closure procedures can rarely be complicated by device embolization, typically towards the aorta. In this case report, we describe the successful percutaneous retrieval of an embolized Amulet device from the left atrium in a patient with previous MitraClips.

CASE PRESENTATION: By guidance of intracardiac echocardiography (ICE) and under local anaesthesia, two guiding systems were introduced into the LA; one to stabilize the device against the lateral LA wall and one large system to retrieve the device. However, the LAA closure device was finally snared by a three-loop snare and pulled across the interatrial septum (IAS) without taking the device into a protective guiding sheath - and this without tearing the IAS.

CONCLUSIONS: In conclusion, percutaneous retrieval of an embolized LAA closure device from the LA is feasible by transseptal approach under local anaesthesia and with ICE guidance.