Emergent surgical retrieval of a left atrial appendage occluder migrated into the left ventricular outflow tract with secondary massive mitral regurgitation: A case report and literature review
Wei Ye,
Wei Zhou,
Weibing Zhao,
Jingjing Mao,
Wei Wang,
Liang Wei,
Linghui Zhao,
Yan Xu,
Jing Yu,
Zhi Fu,
Qiang Wang,
Zhuan Zhang
Affiliations
Wei Ye
Department of Anesthesiology, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Department of Anesthesiology, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Wei Zhou
Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012, China
Weibing Zhao
Department of Anesthesiology, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Department of Anesthesiology, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Jingjing Mao
Department of Anesthesiology, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Department of Anesthesiology, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Wei Wang
Heart and Great Vessels Center, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012, China
Liang Wei
Cardiology Center, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Cardiology Center, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Linghui Zhao
Cardiology Center, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Cardiology Center, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Yan Xu
Department of Operating Room, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Department of Operating Room, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Jing Yu
Department of Operating Room, Huai'an Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, 223200, China; Department of Operating Room, the Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, 223200, China
Zhi Fu
Heart and Great Vessels Center, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012, China
Qiang Wang
Heart and Great Vessels Center, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012, China; Yangzhou Institute of the Heart and Great Vessels, Yangzhou University, Yangzhou, Jiangsu, 225012, China; Corresponding author. Heart and Great Vessels Center, the Affiliated Hospital of Yangzhou University, China.
Zhuan Zhang
Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012, China; Yangzhou Institute of the Heart and Great Vessels, Yangzhou University, Yangzhou, Jiangsu, 225012, China; Corresponding author. Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, China.
Thrombotic complications of atrial fibrillation continue to pose a significant challenge in clinical practice today. Left atrial appendage occlusion (LAAO) has emerged as a promising alternative to oral anticoagulation for high-risk patients with atrial fibrillation. However, despite the potential benefits, there is still the possibility of life-threatening complications such as device dislocation. In this case study, we present a patient who experienced severe hemodynamic disturbances due to the embolization of LAAO device into the left ventricular outflow tract, resulting in a torn mitral valve and secondary massive mitral regurgitation, just 3 hours after the procedure. As a result, emergent surgical intervention was required to remove the device and repair the mitral valve. We also conducted a review of previous studies on the retrieval of dislodged left atrial appendage occluders through surgical procedures. It is crucial to maintain vigilance, foster interdisciplinary collaboration, and respond promptly to ensure the safety and efficacy of LAAO procedures.
