Left atrial appendage occlusion using a Watchman device in a transplanted heart with biatrial anastomosis

Catheter Cardiovasc Interv. 2019 Mar 1;93(4):758-760. doi: 10.1002/ccd.28027. Epub 2018 Dec 13.

Abstract

A percutaneous left atrial appendage (LAA) occlusion using a Watchman device was performed in a patient with prior biatrial anastomosis orthotopic heart transplant (OHT). Due to the anatomical changes following biatrial anastomosis, transesophageal echocardiography (TEE) imaging and transseptal puncture become technically challenging. We describe how the standard LAA views on TEE were obtained for device sizing, and how the transseptal puncture was modified to cross the scarred septum. This case demonstrates that LAA occlusion using a Watchman device in biatrial anastomosis OHT is safe and can successfully be done.

Keywords: biatrial anastomosis; left atrial appendage occlusion; orthotopic heart transplant; transseptal puncture; watchman device.

Publication types

  • Case Reports

MeSH terms

  • Action Potentials
  • Aged
  • Anastomosis, Surgical
  • Anticoagulants / therapeutic use
  • Atrial Appendage / diagnostic imaging
  • Atrial Appendage / physiopathology*
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization / instrumentation*
  • Equipment Design
  • Heart Rate
  • Heart Transplantation*
  • Humans
  • Male
  • Platelet Aggregation Inhibitors / therapeutic use
  • Punctures
  • Treatment Outcome

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors