Left atrial appendage perforation with Watchman device implantation: Strategies for surgical repair

J Card Surg. 2021 Jan;36(1):398-400. doi: 10.1111/jocs.15145. Epub 2020 Dec 1.


Percutaneous occlusion of the left atrial appendage is increasingly being used as an alternative for stroke prevention in patients with non-valvular atrial fibrillation at high risk of complications from long term anticoagulation. We describe a case of left atrial appendage perforation during Watchman device implantation requiring emergency repair of the left atrium using sternotomy and cardiopulmonary bypass. Technical considerations for surgical decision making are discussed; in hemodynamically unstable patients as well as those at high risk for embolization.

Keywords: atrial fibrillation; cardiac electrophysiology; left atrial appendage exclusion; left atrial perforation.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants
  • Atrial Appendage* / diagnostic imaging
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / surgery
  • Embolization, Therapeutic*
  • Humans
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome


  • Anticoagulants