Surgical Repair of Left Atrial Appendage Perforation by Percutaneous Closure Device

Abstract

An eighty-one-year-old man with non-valvular atrial fibrillation underwent left atrial appendage closure with a percutaneous device. Just after the release of the device, cardiogenic shock and pulseless electrical activity with cardiac tamponade were observed. Drainage of pericardial effusion and establishment of percutaneous cardio-pulmonary support were emergently performed. However, because of uncontrollable bleeding, the conversion to open surgical repair was decided by our heart team. Removal of the device and occlusion of the orifice of the left atrial appendage were performed. This case report emphasizes the importance of taking quick and appropriate surgical conversion for any complication of a percutaneous left atrial appendage closure device.