Delayed cardiac tamponade after simultaneous transcatheter atrial septal defect closure and left atrial appendage closure device implantation: a particular case report

摘要

Percutaneous left atrial appendage (LAA) occlusion evolved as an alternative treatment to the patients who are contraindicated or cannot tolerate oral anticoagulants with nonvalvular atrial fibrillation (AF) at risk of stroke or systemic embolism. Abnormal hemodynamic changes in elder atrial septal defect (ASD) patients cause remodeling of the left atrium, which eventually leads to right heart failure. As the ASDs elderly are associated with a higher incidence of AF, simultaneous transcatheter ASD and LAA closure has become a new effective therapeutic strategy. However, only a limited number of articles involving cardiac tamponade complications have been published in the literature. What's more, previous studies involving early hemodynamically irrelevant pericardial effusion after the procedure attribute to multiple repositioning attempts of LAA occluder or delivery sheath injured the atrial wall. We hereby describe a particular case of simultaneous closure of LAA and ASD, who was transferred to surgery for unacceptable delayed cardiac tamponade and may suggest that abrasion effect of LAA occluder disks might be potential risk of delayed cardiac tamponade after LAA closure.