Simultaneous Endocardial and Epicardial Approach for Successful Closure of Left Atrial Appendage With Difficult Anatomy.

ABSTRACT:

Background

Left atrial appendage closure (LAAC) is increasingly used for stroke prevention; however, left atrial appendage (LAA) anatomy may pose significant challenges.

Case summary

A 67-year-old man with paroxysmal atrial fibrillation, CHA₂DS₂-VASc Score of 3, and recurrent falls was referred for LAAC. Owing to challenging anatomy noted during preoperative imaging, epicardial access was obtained at procedure onset. Following multiple unsuccessful endocardial attempts, LAAC was successfully achieved by an epicardial device.

Discussion

Preprocedural imaging can identify challenging LAA anatomy and assist in procedural planning. In patients with challenging LAA anatomy, obtaining epicardial access up front before endocardial closure attempts offer

SUBMITTER: Katapadi A 

PROVIDER: S-EPMC12441508 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature