Yu K, Mei YH. Left atrial appendage occluder detachment treated with transthoracic ultrasound combined with digital subtraction angiography guided catcher: A case report. World J Clin Cases 2024; 12(6): 1157-1162 [PMID: 38464917 DOI: 10.12998/wjcc.v12.i6.1157]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2024; 12(6): 1157-1162 Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1157
Left atrial appendage occluder detachment treated with transthoracic ultrasound combined with digital subtraction angiography guided catcher: A case report
Kai Yu, Yun-Hua Mei
Kai Yu, Department of Ultrasound, Wuhan Dongxihu District People's Hospita, Wuhan 430400, Hubei Province, China
Yun-Hua Mei, Department of Infectious Diseases, Wuhan Dongxihu District People's Hospital, Wuhan 430400, Hubei Province, China
Author contributions: Yu K designed this article; Yu K collected case data and images; Mei YH has played a significant role in literature retrieval work; Mei YH drafted the initial draft; Mei YH revised the manuscript based on the editor's comments; Yu K reviewed the manuscript and kept track of the progress.
Informed consent statement: The patient and their family have signed an informed consent form for treatment.
Conflict-of-interest statement: All authors have declared no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: November 3, 2023 Peer-review started: November 3, 2023 First decision: January 5, 2024 Revised: January 11, 2024 Accepted: February 3, 2024 Article in press: February 3, 2024 Published online: February 26, 2024 Processing time: 108 Days and 20.6 Hours
Abstract
BACKGROUND
There are very few cases of cardiac occluder detachment, and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment. This case innovatively used ultrasound guidance combined with digital subtraction angiography (DSA) to completely remove the occluder, accumulating some experience.
CASE SUMMARY
The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation. After the surgery, the occluder fell off and became free in the left ventricle, which is very dangerous. We innovatively used ultrasound guidance, combined with DSA, and interventional surgery to successfully capture the free occluder using a catcher, completely remove it, and then re implant a new left atrial appendage occluder. After the surgery, the patient recovered very well.
CONCLUSION
The size selection of the occluder is slightly conservative, and the shape of the left atrial appendage opening is irregular.
Core Tip: A case of successfully removing the detached left atrial appendage occluder using a catcher under the combined guidance of transthoracic ultrasound and digital subtraction angiography.
