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Hyperdynamic Left Atrial Appendage May Increase the Risk of Perforation During Left Atrial Appendage Closure-- A Case Series
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  • Steven Filby,
  • Salvatore Savona ,
  • Luis Augusto Palma Dallan,
  • Zachary Garrett,
  • Mahmoud Houmsse
Steven Filby
University Hospitals

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Salvatore Savona
The Ohio State University
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Luis Augusto Palma Dallan
University Hospitals
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Zachary Garrett
The Ohio State University
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Mahmoud Houmsse
The Ohio State university
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Abstract

Introduction: Delayed pericardial effusion following WATCHMAN FLX implantation is not well understood. We present a case series of two patients with hyperdynamic left atrial appendages (LAA) who developed delayed pericardial effusions following WATCHMAN FLX™ implantation. Methods: Successful left atrial appendage closure was performed in 2 patients with paroxysmal atrial fibrillation using the WATCHMAN FLX™ device. Both patients had hyperdynamic left atrial appendages noted during their procedures. Intra-procedure course was uncomplicated. Results: Delayed pericardial effusion occurred necessitating drainage in both cases. Conclusion: While exact mechanisms remain unclear, sinus rhythm and the presence of a hyperdynamic LAA may play a role. Understanding the interaction of the appendage and the delivery system may help to reduce the likelihood of this rare, but serious, complication. Keywords: Atrial fibrillation; Left Atrial Appendage Closure; Pericardial Effusion; Pericardiocentesis.