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Recurrent syncope after left atrial appendage occlusion
Author(s) -
CruzGonzalez Ignacio,
PerezRivera JoseAngel,
Bethencourt Armando
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25608
Subject(s) - medicine , contraindication , atrial fibrillation , left atrial appendage occlusion , occlusion , cardiology , mitral regurgitation , stenosis , syncope (phonology) , surgery , stroke (engine) , complication , warfarin , mechanical engineering , alternative medicine , pathology , engineering
We present the case of a 72‐year‐old woman with permanent atrial fibrillation and contraindication to long‐term oral anticoagulant therapy who underwent left atrial appendage (LAA) occlusion. A 24‐mm Amplatzer Cardiac Plug (St Jude Medical) device was deployed. The inferior part of the external disc of the device appeared to be over the posterior leaflet of the mitral valve but no significant mitral stenosis or mitral regurgitation was detected before deployment. After the procedure the patient suffered several syncopes when she tried to stand up. A transesophageal echocardiography (TEE) was performed and no significant differences on the device position were detected, it was not possible to perform the TEE in a stand‐up position due to the patient symptoms (hypotension, tachycardia, dizziness, and loss of consciousness). After discussion with the surgical team, surgical removal of the device and surgical exclusion of LAA was performed. The symptoms disappeared and the patient was discharged. In the best of our knowledge, this is the first time that recurrent syncope has been described as a complication of LAA occlusion. © 2014 Wiley Periodicals, Inc.