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<p>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&#xa0;mm residual communication following incomplete LAA closure. Percutaneous closure was performed using a 31&#xa0;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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • Mert Doğan,
  • Ahmet Hakan Ateş,
  • Cem Çöteli,
  • Uğur Nadir Karakulak,
  • Hikmet Yorgun,
  • Mehmet Levent Sahiner,
  • Ergun Barıs Kaya,
  • Kudret Aytemir

摘要

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.