Management of device embolization following left atrial appendage closure: Two cases and a review of the literature

Abstract

Objectives: Device embolization (DE) following left atrial appendage closure (LAAC) is a severe but uncommon complication, and limited data address optimal management strategies for this condition. This review presents two cases of device embolization (DE) following LAAC and discusses risk factors, incidence, and management strategies through a literature-based approach.

Methods: A comprehensive literature review was conducted, including studies focused on DE after LAAC, examining percutaneous and surgical retrieval techniques, procedural success, and patient outcomes.

Results and conclusion: DE incidence ranges from 0.6% to 1.5%, with improper device sizing and anatomical factors as primary risk factors. Percutaneous retrieval, through transseptal or transarterial approaches, demonstrates high procedural success rates, while surgical retrieval remains an option for complex cases. Our review suggests that with experienced operators, tailored percutaneous strategies effectively manage DE following LAAC.

Keywords: atrial fibrillation; device embolization; left atrial appendage closure; percutaneous retrieval techniques.