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., ...More

BMC Cardiovascular Disorders, vol.26, no.1, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.1186/s12872-026-05689-w
  • Journal Name: BMC Cardiovascular Disorders
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Hacettepe University Affiliated: Yes

Abstract

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.