Successful use of Cardioform Septal Occluder Device in the Management of Cardiac Tamponade as a Complication of Left Atrial Appendage Closure: A Case Report

Background: While the incidence of major procedural complications during left atrial appendage (LAA) closure is relatively infrequent (<1%-2%), pericardial tamponade is one of the most serious and life threatening, with an overall incidence of 1.3%. While surgical intervention may be required, reversal of anticoagulation, intravascular volume expansion, blood products transfusion, and percutaneous drainage is adequate in most cases.

Case Report: A 77 year old female underwent transseptal puncture for LAA closure with the Watchman device that was complicated by hemorrhagic pericardial effusion leading to tamponade. This was successfully treated with the deployment of a Carioform 25mm septal occluder device.

Conclusion: Early recognition and treatment of iatrogenic pericardial effusion is crucial to decrease the morbidity and mortality of this dreaded complication. To the best of our knowledge, this is the first case to report the successful use of a Cardioform septal occluder device in a potential, life threatening pericardial effusion complicating LAA closure. This represents a novel use of this device that maybe helpful in similar critical life-threatening scenarios.