Work

Extracting a Malpositioned Occluder Device Using Endovascular Forceps

Year: 2025

Type: article

Abstract: BACKGROUND: Transcatheter left atrial appendage occlusion (LAAO) is a low-risk procedure with a <1.0% risk of malposition. CASE SUMMARY: catheter (AngioDynamics) was advanced into the left atrium and a 10-mm Raptor grasping forceps (Steris) was introduced via the AngioVac catheter. Using the Raptor, the Watchman FLX was grasped and with cautious, sustained force extracted into the AngioVac (Video 1) and out of the body intact (Figure 1). A 28 mm Amulet device (Abbott) was then implanted. DISCUSSION: While alternative approaches to LAAO device retrieval have been described, this is to our knowledge the first report describing the use of an AngioVac catheter to extract a malpositioned Watchman FLX (Video 2) and achieving successful LAAO by replacement with an Amulet. TAKE-HOME MESSAGE: Implanting proceduralists must be equipped to salvage high-risk complications such as device malposition.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104639

Authors: Sumon Roy, Hooman Bakhshi, Hamza Aziz, Rani Hasan

Institutions: Boston Medical Center, Johns Hopkins University, Johns Hopkins Medicine

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850