Percutaneous closure of residual leak after surgical left atrial appendage ligation: a case of stroke prevention in high-risk atrial fibrillation


DOĞAN M., ATEŞ A. H., ÇÖTELİ C., KARAKULAK U. N., Yorgun H., ŞAHİNER M. L., ...Daha Fazla

BMC Cardiovascular Disorders, cilt.26, sa.1, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1186/s12872-026-05689-w
  • Dergi Adı: BMC Cardiovascular Disorders
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Incomplete surgical left atrial appendage (LAA) closure is associated with increased thromboembolic risk in atrial fibrillation patients. We present a case of successful percutaneous closure of a significant residual leak following surgical LAA ligation. A 64-year-old female with atrial fibrillation (CHA₂DS₂-VASc score 4), prior surgical interventions including LAA ligation for thrombus formation, presented with ischemic stroke despite anticoagulation. Transesophageal echocardiography revealed a 10 mm residual communication following incomplete LAA closure. Percutaneous closure was performed using a 31 mm Amplatzer Amulet device with successful leak elimination. Percutaneous closure of residual leaks following incomplete surgical LAA closure represents a viable alternative to repeat surgery in high-risk patients. Individualized antithrombotic therapy is essential for optimal outcomes.